How to Learn "Hands-Free" Equalization

Most people are already capable of hands free but in a much milder version than that required for freediving. If you are able to take a commercial flight without persistent pain in your ears or without resolving the pain using a Frenzel or Valsalva maneuver, then you are able to open your eustachian tubes without the assistance of your hands. The difference between opening the eustachian tubes during flight and performing VTO while freediving is caused by the greater pressure created by water and the faster pressure changes caused by the dive descent. This makes the actual VTO technique a bit more challenging than just opening the tubes during flight. Regardless, opening the tubes is the foundation of VTO.

Opening Eustachian Tubes

The triangular-shaped eustachian tube opens by a twist from your tensor veli palatini (TVP). The TVP is a small muscle attached to the skull in the soft pallet area next to the last molar on the roof of the mouth. You might be able to do this involuntarily during a flight, but not everyone can execute this maneuver at will right from the off. While learning TVP voluntary activation, you can use visual, audible, and even tactile cues so you have a clear vision of your uvula. Attempt to move it up and down. Activating your TVP also creates tension in the  palatopharyngeal muscle. If you do this right, you will see the uvula rising and the larynx closing as the TVP is activated. On the outside, you might be able to see the larynx (Adam’s apple) rise as well. This tension is often described as the “last part of a yawn.” TVP activation is also often accompanied by a crackling sound in the ears. You can even feel TVP activation when gently touching the area next to the last upper molar.

Once you are sure that you can activate the TVP at will, you can check whether its strength and range of motion is sufficient to open the tubes. Try to hum audibly. The sound should travel through the open tube and fill up your head. Protruding the jaw forward or wiggling it from side to side might be necessary to create enough space for the tubes to be held open.

Opening Tube Exercises

Because we don’t use the TVP that often even on land, thorough practice is essential to develop good coordination and strength for its use in freediving equalization. Commitment to TVP training should match the demand of diaphragm/chest and shoulder flexibility training (it should be part of your daily routine).

Pull the tubes open and test them by humming. If the humming does not fill up your head even when your TVP is activated, the tubes are not open. This is somewhat common at the beginning, and it is part of the training curve. Try to adjust your jaw position first as suggested above. A gentle pressurization may be needed to stretch the tube into an open state. This is done by pinching the nose and equalizing via the Frenzel maneuver and then gently holding for fifteen to twenty seconds. Repeat several times to relax the surrounding muscles. Once you can open the tubes and hear the loud hum, start working on coordination by progressively working on achieving three hundred repetitions. It may seem excessive, but, in reality, three hundred equalizations represent a few hours of freediving and take five to ten minutes to execute.

Strength of TVP is a crucial factor in overcoming the increasingly negative pressure during descent, which collapses the eustachian tubes and makes it harder to open them. Start challenging yourself to hold your tubes open for longer and longer periods of time. The goal is to reach ten minutes in a continuous hold without closing. Again, test the state of the tubes by humming.


VTO Maneuver

The VTO maneuver is essentially a variation of the Frenzel maneuver, aided by a conscious opening of the eustachian tubes. Mastering the Frenzel maneuver is essential to deep diving with VTO; therefore if you have any doubts about your ability to execute this maneuver successfully, stop. It is better to master this first before one invests time in hands free. When equalizing with pure Frenzel, the air is simply pushed into the naturally “twisted” eustachian tube to open it, just like a loose kink in a garden hose can be straightened when enough water pressure is pushed through it. Using VTO assists this maneuver with opening the tubes and thus severely decreases the pressure needed to get the air into the middle ear. The air held in the mask is then sufficient and, therefore, pinching the nose is not necessary.

1.    With a mask on, place the tip of your tongue behind your front teeth and form a grape-sized ball of air on top of the tongue.
2.    Close the throat.
3.    Lower the soft palette.
4.    Pull the tubes open at the same time as pushing the air back and up. Imagine “swallowing upward.”

VTO Maneuver Exercises

Practice VTO on dry land first. Make sure your mask strap is adjusted for a proper seal. Once you create muscle memory and do not have to think when executing this maneuver, you can try to take it into the pool. Start in the shallow end in the head-up position, lowering yourself only a few feet below the surface. When this becomes easy, move into the deeper portion of the pool, but keep the vertical head-up position while practicing.
Once the slightly increased depth proves not to be a challenge, you can dedicate some time from your open water line training to “head-up” pull downs to test your VTO at slightly deeper depths. There is no need to pull deeper than 10–15m at this stage of training to improve your technique.

When the “head-up” VTO is mastered, you can try this in prone position (face down). Doing this in a pool while holding onto a weight belt with just enough weight for a nice slow descent is the best way to keep your mind on the technique and your body’s feedback without having it be preoccupied with controlling the descent.

 Only when consistent and comfortable, can you increase the challenge by adding some weight and slightly increasing the descent speed while still keeping the prone position. Progressive increase of speed based on your comfort (consistency and relaxation) in the prone position helps with mastering the timing and muscle coordination for VTO.

After becoming proficient in the prone VTO maneuver, attempt VTO in an angled descent and eventually in a full, head-down descent. It may be beneficial to try head-down on dry land first because the blood rush to the head can affect one’s comfort, and later ease into the head-down VTO in the water. Similar to the previous exercises, starting with a very slow and controlled descent (e.g., pulling down) and progressively increasing the speed and depth is the key to steady progression.

Things to Keep in Mind

Progress in learning VTO may vary widely (hours to months) because individuals have different muscle strength and sensitivity and also face physiological and anatomical differences. However, if you can pass the airplane test mentioned at the beginning, it is only a matter of practice before you succeed with VTO.

Being properly hydrated and warmed up prior to attempting any of the aforementioned exercises will go a long way. Chewing gum for five to ten minutes prior to these exercises or your dive session will also help with proper blood flow through the critical areas involved with equalization. Make sure you follow “hydration rules for freedivers” from your F.I.I. Level 2 Freediver manual to support this blood flow and decrease the stickiness of the membranes covering your nasal passages and eustachian tubes.

When using VTO, the preequalization technique you have (we hope) made second nature to your dives since your F.I.I. Level 1 Freediver course is even more crucial now than before. Because VTO uses much less pressure to equalize than Frenzel, once the tubes are squeezed shut by water pressure, it will be very difficult to open up again. This also leads to another skill that will need to be developed: VTO requires a much higher equalization frequency than Frenzel.

Best of luck, have fun, and dive safe.