How to Equalize Your Ears When Scuba Diving

Ear pain is one of the things new divers worry about most before their first dive. PADI says almost every diver has trouble equalizing at some point, especially when they are starting out, and that with proper training and technique most divers can equalize comfortably.

This guide covers why your ears hurt on the way down, how to equalize, when to start, what to do when they won't clear, and the signs that mean you should stop. Everything here comes from DAN (Divers Alert Network) and PADI (a dive training organisation). This is not medical advice. For your ears and your health, always ask a doctor.

Why do your ears hurt when you dive?

Your middle ear is a space filled with air. A small tube, the Eustachian tube, connects it to your throat. When you swallow, the tube normally opens. That soft "pop" or "click" you sometimes hear is this tube.

As you descend, the pressure around you rises. DAN explains that the eardrum is pushed inward. If you don't bring the pressure inside your ear up to match, the difference keeps growing until it hurts, and if it grows large enough the eardrum can rupture. Divers call matching the pressure "equalizing": opening the Eustachian tube so air can reach the middle ear.

An article on the PADI blog, from DAN, says middle ear barotrauma (injury to the middle ear from pressure) is the most common pressure-related ear injury.

How to equalize: the methods DAN and PADI describe

PADI says the techniques that help you equalize are all taught on the Open Water course, for example swallowing, yawning or gently blowing against a pinched nose. DAN names each method:

Valsalva: pinch your nose and blow gently through it. The PADI blog says this is the method most divers learn, and warns that it is easy to blow too hard. Don't blow hard, and don't hold the pressure for more than five seconds.
Toynbee: pinch your nose and swallow. DAN says this works well if you need to equalize on the way up.
Frenzel: pinch your nose, tighten your throat muscles and make a "K" sound.
Lowry: pinch your nose and blow gently while you swallow, Valsalva and Toynbee together.
Edmonds: push your jaw forward, then use Valsalva or Frenzel.
Voluntary tubal opening: yawn or move your jaw. The PADI blog says it takes practice.
Passive: happens on its own on the way up, with no effort.

When to start and how often

DAN's tips:

Start before you go down: at the surface, before you descend, equalize gently once.
Go down feet first if you can, and use a descent line or anchor line to control your speed.
Equalize often early on: gently, every few feet, for the first 10 to 15 feet.
Don't bounce up and down.

The PADI blog adds that if you don't equalize early or often enough, the tissue at the end of the tubes can close them.

What to do when your ears won't clear

Stop going down: PADI says the most important rule when equalizing is never to force it or keep descending.
Go up a little: ascend a few feet or about a metre to reduce the pressure, then try again (PADI).
Tilt the blocked ear towards the surface: DAN says this may help.
Still blocked? End the dive: DAN says if you can't equalize, abort the dive.

Why you should never force it

DAN puts it simply: pain is not acceptable. Pain means you have gone down without equalizing enough, so ascend a few feet until it stops. DAN also says going down without equalizing can ruin a whole dive trip or cause permanent damage and hearing loss.

The PADI blog explains that forcing air against tubes that are already closed can lock them shut, and that blowing too hard can rupture the round and oval windows, small openings in the inner ear.

Can you dive with a cold, a blocked nose or allergies?

DAN says colds and other upper respiratory infections, hay fever, allergies, smoking or a deviated nasal septum can make equalizing harder.

Decongestants and nasal sprays can reduce swelling in the nose and ears, but DAN warns that decongestants can have side effects. Check with your doctor first, and don't use one before diving if you have never tried it before. Over-the-counter nasal sprays used again and again can cause rebound congestion. Whether you can dive while unwell is your doctor's call.

Signs to stop diving and see a doctor

DAN says that if you notice any of these during a dive, abort the dive:

Ear pain
Vertigo (a spinning feeling)
Sudden hearing loss

If the symptoms don't go away, DAN says don't dive again and see a doctor.

How your mask helps you equalize

Most ways to equalize need you to pinch your nose, so a dive mask must cover it. PADI's mask guide says:

The mask encloses your nose, so you can adjust for pressure changes by breathing out through it.
Finger pockets around the nose let you pinch it to equalize your ears.
When you try a mask on, try pinching your nose.

That is why swimming goggles that leave your nose out can't be used for scuba. More on choosing one in Choosing a dive mask, or compare the masks we carry.

Learn it with an instructor first

PADI says equalizing techniques are taught on the Open Water course, and you practise skills in a pool or pool-like water before you dive in the sea. More on the course in Learn to dive: Open Water, and on other diving risks in Is scuba diving dangerous?

Before your course day, watch our free video 5 things new divers should know (in Thai) on YouTube.

Frequently asked questions

My ears hurt when I dive. What should I do?

Stop going down and don't force it. Ascend a few feet or about a metre and try again. If they still won't clear, end the dive. That is what PADI and DAN advise.

What is the Valsalva maneuver?

The equalizing method most divers learn: pinch your nose and blow gently through it. The PADI blog warns not to blow hard and not to hold the pressure for more than five seconds.

Can I dive with a cold or a blocked nose?

DAN says colds and allergies can make equalizing harder, and decongestants can have side effects. Always ask your doctor first.

Should I see a doctor if my ear hurts after diving?

DAN says if you feel ear pain, vertigo or sudden hearing loss during a dive, abort the dive, and if the symptoms persist, don't dive again and see a doctor.