How to Equalize Your Ears (Diving & Freediving)

Why your ears hurt underwater

As you descend, water pressure rises and pushes in on your eardrum. Behind the eardrum is an air space, the middle ear, connected to the back of your throat by the Eustachian tubes. Equalizing simply means adding a little air into that space through those tubes to balance the pressure so the eardrum is not pushed painfully inward. The pressure change is greatest near the surface (the first few meters), which is exactly why so many people struggle right at the start of a descent.

The equalisation techniques, one by one

• Valsalva (the common one): pinch your nose and gently blow against it, as if blowing your nose softly. Easy to learn; the catch is it must be done gently and early.
• Toynbee: pinch your nose and swallow. Often works well and is gentle.
• Voluntary tube opening: wiggle your jaw, or move it forward, as if starting a yawn, to open the tubes.
• Frenzel (for freedivers): a more advanced technique using the tongue and throat rather than the lungs, which works better at depth and on a held breath. Freedivers learn this in a course.

Most divers start with Valsalva or swallowing. If one does not work for you, try another, and combine them (for example pinch, and swallow while gently blowing).

The rules that actually keep you safe

The Divers Alert Network (DAN) and every dive agency stress technique-and-timing over force:

• Equalize early and often. Start at or just below the surface and equalize every meter or so, before you feel any pressure. Waiting until it hurts is the classic mistake, by then the tubes can lock shut.
• Be gentle. A soft, brief effort is all it takes. A hard, forceful Valsalva, especially late or against a blocked tube, can injure the inner ear.
• Descend slowly, ideally feet-first. A head-down, fast descent makes equalizing harder; going down a line feet-first, slowly, makes it easy.
• Stuck? Stop, ascend a little, try again. Rising a meter or two relieves the pressure so the tubes can open. Never push down through pain.
• Pre-equalize. Gently equalizing on the surface before you descend can give you a head start.

The reverse block (going up)

Equalizing is usually about going down, but air also has to escape on the way up. If congestion traps expanding air in your ear or sinuses as you ascend, that is a reverse block, and it can be more uncomfortable and harder to manage than a descent problem. The fix is to ascend slowly, stop, and let the air work its way out. It is another reason not to dive congested.

Why “gently” is the word that matters

Every equalisation guide says early, gently, often. The clinical literature explains which of those three words is protecting you from the worst outcome, and it is the middle one.

A 2026 review in Otolaryngologic Clinics of North America sets out the mechanism: otitic barotrauma “results from failure to equalize pressure changes across gas-filled ear spaces, most commonly due to Eustachian tube dysfunction”, and it is “highly prevalent among divers and aircrew, with middle ear barotrauma being the most frequent presentation”. The symptom list is the one divers recognise: “otalgia, hearing loss, tinnitus, fullness, vertigo, and tympanic membrane injury”.

Then the sentence to take down with you: “Inner ear barotrauma is less common but potentially severe, especially after forceful equalization.” The injury that can cost you hearing permanently is associated not with failing to clear but with clearing too hard. That is the whole argument against the big determined Valsalva at depth when nothing is moving: the forceful attempt is itself a risk factor, so the correct response to an ear that will not clear is to ascend a metre and try softly, not to push harder.

When to stop, and when to see a doctor

If you cannot equalize after stopping and trying gently, end the dive, a missed dive is far better than an ear injury. See a doctor (ideally one familiar with diving) if you have ear pain that persists after a dive, muffled hearing, fluid or blood from the ear, ringing, or dizziness/vertigo, these can indicate barotrauma and need proper assessment. Persistent trouble equalizing is also worth getting checked, sometimes there is a treatable cause.