Learning to Hands Free Equalize: How I Taught Myself to BTV

Most important to learning hands free equalization is believing it is possible. Since I started freediving in 2017 and experimenting with hands free equalization, I have met many freedivers who were initially unable to hands free equalize, but learned it over time. I want to assure you that it is possible to learn it.

We used to believe that some lucky people could hands free (BTV or VTO) equalize, and then there were the rest of us unlucky ones who had to learn how to Frenzel equalize.

Back in 2017, when I was searching for freediving schools which were open to accepting a student who was learning how to hands free equalize, only one school – Freedive Flow – had the confidence to accept me. Most other instructors told me they only taught students how to Frenzel, and they did not believe it was possible to learn how to hands free equalize.

Today, thankfully, attitudes have changed. More and more freediving instructors, such as Andrea Zuccari, Adam Stern, and Julia Mouce are telling us that one can learn how to hands free equalize.

I started as a struggling freediver in June 2017 who could only Valsalva heads up to 10m, my toes barely reaching the bottom plate to obtain my AIDA 1 certification. I resorted to learning hands free equalization because I struggled with learning the Frenzel technique. But after two years of research, study, and practice, I was able to take my hands free equalization down to my personal best of 52m in September 2019.

In this article, I want to share my personal experience of how I learned it.

1. WHY LEARN HANDS FREE EQUALIZATION?

For three reasons:

1. You do not need to pinch your nose when you wear a mask, which aids in activities like underwater photography and spearfishing.
2. It is known to be the gentlest and most efficient equalization method (Mana, 2011), meaning, with this method, you can probably dive deeper with greater relaxation.
3. It is the most naturalistic method that mimics movements your body does daily – yawning, swallowing, and burping. Your body innately knows how to do it. Learning to hands free equalize teaches you how to exercise involuntary muscles at will.

Now, isn’t that cool?

In my first post about hands free equalization, I challenged myths we have about hands free equalization. In this article, I am going to teach you three exercises that can help you reach a depth of 15 – 20 m with hands free equalization.

If you are an experienced freediver, adapted to deeper depths, you may find that you can go deeper with these techniques. You can also apply these techniques to your mouthfill when you wear a mask.

2. BACKGROUND INFORMATION

Before I begin explaining hands free equalization, I think it is important to educate freedivers that there is a two-step process for a successful equalization. Andrea Zuccari (2018) teaches this well in dividing a successful equalization process into two phases – the air shift and the equalization phase.

Air shift refers to the bringing of air into the mouth from the lungs. One can use different methods, such as abdominal contractions or reverse packing, to shift air into the mouth. One can also bring up different amounts of air, from a small one sufficient to do a Frenzel to a large one that fills the mouth and the throat (the mouthfill) that advanced freedivers tend to prefer.

The air shift is necessary, regardless which equalization method you use, because the goal of equalization is to compensate for the compressed air in the middle ear, and you do so by transferring air from the lungs into the middle ear.

The equalization method refers to how the Eustachian tubes (e-tubes) are opened. There are various techniques one can use to open the e-tubes:

• Valsalva maneuver – not recommended for freedivers but common with scuba divers. It is combined with the air shift technique, where strong abdominal contractions push air directly past the glottis and through the e-tubes into the middle ears.
• Frenzel maneuver – the most commonly taught method. It involves shutting the glottis to trap air in the mouth and nasal cavity and then using the tongue and throat to push this air through the e-tubes and into the middle ears.
• Hands Free maneuver – the “holy grail” of equalization methods where you engage muscles of the eustachian tubes to continually hold them open or periodically open them.

A successful equalization cycle, hence, involves different combinations of air shift and equalization techniques (Zuccari, 2017). One can do one big charge (the process of transferring air from lungs to mouth) and many equalizations before another big charge. Or one can do one small charge and one equalization followed by another small charge and equalization and so on. Or one can perform a gigantic charge and then play around with the big amount of air that is stored in the mouth for equalization (what we call the mouthfill).

Typically when instructors teach about equalization, they focus on equalization techniques rather than air shift techniques. This is likely so because the Frenzel maneuver is a complex one to learn. And this lack of emphasis on air shift techniques is probably why many beginner freedivers don’t even realize that they are constantly using air to equalize.

To perform hands free equalization, you need to master both the air shift and the hands free equalization technique. Many people who are learning how to hands free equalize, do not realize that being able to perform the equalization technique alone is not enough, and it is just as essential to learn how to shift air into the mouth. It is possibly one of the reasons why many find that their hands free only works only on land or to a certain depth.

It is not true that there is a depth limitation to hands free equalization. It is like any other equalization method – the only limit is your ability to keep the air in your mouth and your ability to access this air at depth and your hypoxic limit.

3. WHAT IS HANDS FREE EQUALIZATION?

The Eustachian tubes (e-tubes) connect the middle ears to the oral and nasal cavities. At rest, they are closed to protect the ears from foreign material and infection. But throughout the day, when we talk, chew, swallow, yawn or burp, the e-tubes open to ventilate the middle ear, regulate pressure, and aid in the clearance of excretions from the middle ear. This is a movement that the body does on its own without our conscious control.

When we are diving, the increased pressure exerts a force on our eardrums, which compresses the air in our middle ears. In hands free equalization, we respond to this sensation of pressure on our eardrums, by voluntarily contracting two muscles of the soft palate – the tensor veli palatini muscles the levator veli palatini – to open the e-tubes (see Diagram 1). This allows air from the mouth and nasal cavities to move into the middle ears to equalize the pressure.

There are two types of hands free equalization. One is the intermittent hands free equalization, which involves repeatedly opening the tubes and the other one involves constantly holding the tubes open. The exercises I am going to teach is specific to the intermittent hands free equalization.

Wearing a mask and being able to equalize it is essential to this method. You can also hands free equalize using a nose clip. However, it requires a different approach and technique, and it will not be covered in this article.

You will notice that many people who handsfree equalize wear masks, and they can equalize to deep with the mask. Why is this so? A significant difference between hands free and Frenzel equalization is how mask air is managed. For someone who hands free equalize, the mask is always fully equalized with the mask and the nasal space forming a continuous space. But for someone who Frenzels, the pinching of the nose constantly isolates the mask space from the nasal space.

Because of this, the mask is rarely seen as a hindrance to someone who hands free equalize but as a mere extension of the nasal space. In fact, air from the mask is used to equalize the middle ear as hands free equalization is dependent on the pressure differential between the mask and the middle ears. But to someone who Frenzels, air from the mask is separate from the nasal cavity and never used for equalization. It is an additional space they have to constantly equalize by releasing their pinch a little to avoid the mask squeeze. Hence, the mask is often seen as a hindrance, a waste of precious air, to those who Frenzel and who may find it a relief when they switch to the nose-clip as they go deeper.

On a separate note, you may think you are losing precious oxygenated air when you put so much of it into your mask during your descent, but towards the end of the dive when you are most hypoxic and need it the most, you sniff back this relatively more oxygenated air. You lose nothing at all from filling your mask with air and may in fact stand to gain from recovering this air into your system as you ascend to the surface! Regardless which equalization method you use, try sniffing this air back and see how that makes you feel.

So now you know the secret of Hands Free equalization! To us, the mask is not merely a means for sight; it is also a storage space for air for equalization!

4. MY METHOD

My method closely simulates not just the opening of the e-tubes but the whole process of  a 20 m dive. You must not only be able to open your tubes (Exercise 1). You must also be able to shift air into your mouth and keep your glottis closed after doing so (Exercise 2). You will also need to be able to repeatedly do this as you descend under increasing pressure and time (Exercise 3).

A common complaint of learners of hands free equalization is that they can do it on land but cannot do it in the water. I believe this is so because these people may be able to open the e-tubes on land reliably, but they did not learn how to coordinate this with the required air shift technique and to practice this before proceeding to the water.

I believe my exercises are effective because Exercise 3 simulates the actual conditions of a dive – requiring not only that you use the hands free technique, but also that you shift air into your mask, and continuously repeat this process under the conditions of a breath-hold.

5. THE EXERCISES

In the first exercise, you will learn how to open your e-tubes. In the second exercise, you will learn how to equalize your mask. In the third exercise, you will combine these two movements. In the water, you will repeat the process of first equalizing your mask and then opening your e-tubes.

Exercise 1: Pinch, Swallow, and Release

Pinch your nose and swallow to suck air out of your middle ears. You will feel like your eardrums move towards you, the way it feels when you descend in the water. This is the reverse of equalization. Instead of putting air into the ears, we take it out (Laminar, 2008).

With this, you will feel uncomfortable and like you have blocked ears. Now, release this pressure by playing around with yawning. Stretch out the space between the roof of your mouth and the floor of your mouth. Feel like there’s asniff big ball of air in your mouth! Try varying degrees of yawning. Exaggerate. If not yawning, try swallowing and different degrees of it. Stretch out the space between the sides of your mouth, as if someone was pulling on both your ears!

Or try moving of your jaw or wiggling of your ears… Or try a Frenzel movement…

The e-tubes are usually closed because of their intrinsic elasticity, the surface tension of the moist mucosa, and the pressure exerted by surrounding tissues (TVGH, 2013). So sometimes, when they open, you can hear this sound that some people describe as a click or like two sticky surfaces are being separated.

Your goal is to unblock your ears or bring your eardrums back to neutral position by a specific movement. Right now, it might take you 9 out of 10 tries to unblock your ears by the various movements you are experimenting with (10% success rate). But eventually, you and your body will figure out which one is working. And the success rate will increase. Your goal is to bring this success rate to 100%.

Be like a kid again. Be patient. Experiment. Be curious. Be creative.

Give yourself time. Keep practicing and having fun.

For myself, once I got the movement right, I kept practicing it every day, trying to make it clean. To be able to open the tubes with one clean movement. Eventually, I isolated my particular movement – it felt like the beginning of a swallow. Yours might look different from mine, and that’s okay, we are each unique!

Exercise 2: Expelling Little Balls of Air Out of Your Nose

I learned this exercise from Chris Kim of Zen Freediving and Molchanovs. Without inhaling or exhaling any additional air (just as you are now or in the state of your FRC), begin grabbing small balls of air in your mouth and spitting them out continuously.

This shouldn’t be too hard, and it would feel that you can do it forever. Now spit this air not out of your mouth by through your nose. I noticed that I make use of my tongue to pull this air from my mouth and out of my nose. This is the classic “reverse packing” movement.

To know that you’re doing it right, slightly press onto your nose and feel the air puffs coming out as you perform this movement. Your belly should not move as you do this movement.

Play around, as you are spitting air out of your nose, you are also holding your breath. Count how many spits you can do or how long you can do it for.

To mimic depth, spit at a rhythm. Spit a ball and pause for one second, spit again.

Play around with different sizes of spits. Spit a big one by moving your tongue all the way down to collect a big blob of air and imagine your mask expanding out with this. Now spit a small one and imagine your mask barely moving.

One of my friends was unable to reverse pack. If you are unable to do it, try exhaling out instead. Continuously exhale mini puffs from your nose. After one mini exhale, relax your belly, then do another one. And keep repeating this. What you are now doing is the air shift by abdominal contractions. Another form of air shift by abdominal contractions is the Grouper Call. Make the “Mmmm” sound and feel your mouth swelling up like a balloon. Remember to relax your belly after this!

Whether you draw air into your mask through reverse packing or exhaling, air is constantly moving in one direction from the lungs to your mouth, past your soft palate and out of your nose. It is stopped from returning to your lungs through the constant closing of the glottis.

Exercise 3: Combine the Two: Spit/Expel/Exhale and Equalize

Now, we want to combine the two exercises to mimic what a descent in water.

Spit some air out of your nose (or exhale some air out) and now do your hands free movement, and continue with this rhythm.

Now try one spit with two hands free movement and continue with this rhythm.

Now try one spit with three hands free movement… so on and so forth.

Repeat this until you run out of breath. Play around with this to mimic an actual dive.

I like to do this exercise when I walked my dog in the morning. So you can do it anytime! This is not only a fun equalization exercise, but it also works on your breath-hold!

It is also very close to what it is like during a descent in the water. You have to be able to pull air into your mouth and equalize continuously into your breath-hold even as carbon dioxide level builds up.

Practice In the Water

Now, once you can successfully perform this on land, you can translate it into the open water. I would advise beginning with free immersion because it is slower than constant weight and what a learner of equalization needs – a slow pace and the opportunity to grab hold onto the line anytime when equalization is slow.

Now, take the fullest breath you can, relax, and enter the water. Be as completely relaxed as you can be. If you notice any tension, gently take note of it and let it go.

You will feel pressure on your eardrums, just like when you pinch your nose and swallow in Exercise 1. At this time, you perform the movement to release this pressure.

After a few meters, you start to notice that your mask is becoming tight. And now, shift air into the mask (by reverse packing or abdominal contractions) to ensure it is equalized. And continue your descent.

(You may not feel this tightness of the mask until 5 – 10 m or so because you still have plenty of air in the beginning.)

You feel the pressure again on your eardrums. So you perform the hands free movement to release it.

Every time you feel the pressure, you release it with the movement.

Every time you feel the mask running out of air, you put air into it.

The success of hands free equalization depends on how well you can perform and coordinate these two movements. This is linked to how well you can control other equalization muscles involved that I will elaborate more on in the section called “Diagnosis.”

For a start, you can try a rhythm of one mask equalization followed by three hands free equalization movements on repeat, but adjust this according to what you feel comfortable with.

It is normal that when you begin learning this, you will descend slowly. You may need to think hard to open the e-tubes now. But over time, you will think less, and as it becomes more automatic, your speed will increase.

6. WHY I RECOMMEND MY METHOD

If you search online, you will find exercises that teach you a full set of equalization muscle strengthening exercises (e.g., Zalgaler, 2006). My recommended exercises are different and possibly more effective because we are making use of immediate feedback and positive reinforcement, and we simulate an actual dive, performing these techniques in a rhythmic pattern while holding our breaths.

How do you know exactly that you have opened your tubes? Hearing a click is not enough, as there are many sounds we can make inside our head, but it does not mean the e-tubes are open. To know the exact movement that opens the e-tubes, you need immediate feedback. Exercise 1 uses immediate feedback provided by the undoing of the negative pressure to ensure you are indeed opening your e-tubes when you say you are.

My method also uses positive reinforcement. When you perform the right movement (desired behaviour), your ears unblock (reward). Your body learns to perform the right action over time because it is always rewarded when it does the right action and not rewarded when it does the wrong one.

Over time, your body also begins to associate a slight negative pressure with the opening of the e-tubes. This eventually translates into the water – each time pressure is exerted on your ear drums, and it feels slightly uncomfortable, you will release that pressure – now voluntarily, but one day involuntarily.

7. DIAGNOSIS/TROUBLESHOOTING OF ISSUES DURING THE DIVE

To perform a successful dive with hands free equalization, three factors have to be in place (Pelizzari, 2019):

1. Closed glottis (more critical after the first 5-10 meters)
2. Neutral soft palate (so air from the throat can easily travel to the e-tubes)
3. Open Eustachian tubes

A failure to hands free equalize could be owing to any of these three factors and not merely your ability to open the e-tubes. These are some questions to ask yourself to troubleshoot your issue if you encounter a failure to equalize:

1. Am I relaxed? Look out for tension and release it. Go as slow as possible to be relaxed during your dive. When you’re learning something new, you need much mental bandwidth to observe yourself and make mental notes so that you can correct them in your next dive. To be able to do this, give yourself time to figure things out. Keep repeating a dive until you can do it while being conscious of what is happening in your body, especially with the mask space, glottis, and soft palate. With this, you will be able to self-diagnose your issues.
2. Was my glottis open? (An opened glottis causes you to lose the air in your mouth into your lungs – what people who do the mouthfill call ‘swallowing’.) Typically, if you feel the mask smacked tight against your face, it is a clear sign that your glottis was opened. Also, try to take note if your mask leaks when you are having contractions. Some of us have difficulties keeping the glottis shut during contractions and we will need to learn to tuck our chins in and have better control of our throats.
3. Was my soft palate closed? (A closed soft palate blocks the air from your mouth to go into your nose and into the ears.) The e-tube opening is located in the nasopharynx above the soft palate (see Diagram 1). This is why to perform any of the equalization techniques, your soft palate must be at a neutral posiiton, so air can transfer from the oral and throat cavities into the nasopharynx. If your soft palate is not neutral and closed either downwards or upwards, you will experience blockage and be unable to equalize.

8. BENEFITS OF LEARNING HANDS FREE EQUALIZATION

It does sound like hard work learning how to hands free equalize, why then bother? What are some incentives for learning how to hands free equalize? Here, I provide some speculative reasons why there are advantages to learning hands free equalization.

Some of my friends who hands free equalize told me that they prefer wearing a mask compared to a nose clip because there is a buffering effect. If you accidentally forget one equalization, air from the mask can be used for it and so you can catch your rhythm back and continue to equalize. People with a nose clip may not have this luxury and have to turn back at this point.

To many divers who do hands free equalization, the mask is seen as an extension of themselves. Because of this, they are often particularly skillful in the management of air, comfortably putting air into the mask during descent and then sniffing it back later when the air expands during ascent. They are often good at pulling air into their mouths and many may not even need to pack or use a nose clip to reach similar depths as those who Frenzel.

It is an alternative to Frenzel equalization if you have, for whatever reasons, been unable to pick it up. If you have been too used to certain patterns such as Valsalva from your past and undoing certain patterns is too difficult for you, it helps to be able to attain depth through a different route. It is never too late to pick up the Frenzel after you have learned how to hands free. But more likely than not, going back to a more energy-consuming method is not as appealing an option after you have mastered hands free equalization. Though it always helps to have more than one tool in your toolbox!

There is one disadvantage to hands free equalization, it being a method that is dependent on sensitivity to pressure for performance. Having had experiences with mild middle ear squeezes, I noted that if I have an ear strain on just one eardrum, and it becomes more sensitive than the other, it is a tricky situation during my dive. One ear would not yet feel the need for equalization while the other ear is screaming for me to equalize it. This confuses my brain a little.

Unlike Frenzel equalization, where you induce a positive pressure and let your descend neutralize it, hands free equalization relies on a negative pressure that has to be released. Because of this pre-emptive and protective element that Frenzel equalization offers, it may be superior to hands free equalization in some ways. Frenzel equalization, when done on cue, will never allow your ear drums to stretch beyond the neutral position.

Regardless of what methods you use, a reminder to us all not to ‘ride’ our ears! If we cannot equalize, stop and head back, stop going towards the bottom! It is not worth it to hurt ourselves over a competition or certificate!

9. GOING DEEPER

What is next after you have mastered 20 m of hands free equalization? Going deeper is a matter of developing mastery over the techniques and skills you have learned in this article (different ways of opening the tubes or even constantly keeping them open, different amounts of air to bring into the mouth, self-awareness to diagnose issues of the glottis and soft palate as you go deeper).

The reason why I limited the dives to 20 m is because I have beginners in mind. Beyond 20 m, you will also need to become adapted to greater pressure (including a more flexible chest and diaphragm), have a longer breath-hold, and greater relaxation during freefall. If you are an experienced and adapted freediver with Frenzel already, you may be able to take these skills deeper immediately.

I am currently at the stage of practicing my hands free mouthfill. Just yesterday, on the 22 of January 2020, I took a hands free mouthfill at 18-20m and went down to 40m with it. I will be working on mastering this, and when I do, I will teach you how to do it in another article. 🙂 The mouthfill is so much more comfortable than reverse packing!

10. CONCLUSION

The truth about learning how to hands free equalize is that it is not any different from learning how to Frenzel or how to do the Mouthfill. Depending on your past experience and unique anatomy, learning one technique may be harder for you than another. I have heard of theories that speakers of certain languages will find Frenzel easier and speakers of other languages will find hands free equalization easier, simply because our spoken languages prime our ability to make certain movements with our mouth and throats. But regardless, with good awareness, effective exercises, time and practice, and patience, you can learn any technique that you wish to learn.

Here is a video of me using hands free equalization during a FIM dive at the Caribbean Cup Freediving Competition in 2019. 🙂

11 April 2022: I have launched my equalization course that uses a myofunctional approach to equalization education. Read more about it at this website: https://equalizationgym.com/

ACKNOWLEDGEMENT

Thank you Evon Tan for trying out the exercises and the feedback you gave me, Mala Krishnasamy for reading through and spotting my language errors, and Katelyn McDonald for the beautiful illustration.

REFERENCES

Chua, S. (2017). My Hands Free Experience. Retrieved 16 September, 2019, from https://www.facebook.com/notes/shuyi-chua/my-hands-free-experience/10155790654745955/

Chua, S. (2018a). Hands Free Equalization for the Beginner and the Curious. Retrieved 14 September, 2019, from https://therapystop.wordpress.com/hands-free-equalization-for-the-beginner-and-the-curious/

Chua, S. (2018b). An Experience with Middle Ear Trauma. Retrieved 2 October, 2019, from https://zenfreediving.org/blogs/articles/an-experience-with-middle-ear-trauma-by-shuyi

Chua, S. (2019a). Reverse Packing + BTV using Mask. Retrieved 16 September, 2019, from https://www.facebook.com/notes/shuyi-chua/reverse-packing-btv-using-mask/10157910007675955/

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Mana, F. (2011). Equalization for freediving. Milano, IT: Magenes

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Stern, A. (2018). No Hands Equalization Retrieved 16 September, 2019, from https://www.adamfreediver.com/equalisation/no-hands-equalizations/

Taipei Veterans General Hospital (TVGH) (2013). Patulous E-Tubes. Retrieved 15 September, 2019, from https://wd.vghtpe.gov.tw/ent/files/002.pdf

Zalgaler, D. (2006). A Manual for BTV (VTO – Voluntary Tubal Opening): A Step-by-Step Guide to Hands Free Equalizing for Freedivers and Scuba Divers. Translation from French. Retrieved 16 September, 2019, from http://eng.apnea.co.il/edu/btv_eng.doc

Zuccari, A. (2016). La Compensazione Hands Free. Retrieved 14 September, 2019, from https://www.youtube.com/watch?v=xO4Kh7qtgrE

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Zuccari, A. (2018). Photo from Equalization Academy’s post. Retrieved 23 September, 2019, from https://www.facebook.com/758397007651774/photos/a.769677903190351/1105154042976067/?type=3&theater