Using the Toynbee Maneuver to Equalize

Your body will need to adapt when you are subjected to different surrounding pressures. You will feel the pressure change in your ears as your middle ears are dead air spaces which need to be equalized. If you do not equalize this space to match the pressure in your outer and inner ears, then you may get painful middle ear barotrauma. So let’s have a look at a common and easy way to equalize your ears by using the Toynbee Maneuver.

The Toynbee Maneuver

The Toynbee Maneuver is an act to equalize your middle ear to match the surrounding pressure. It is a simple method to learn. All you have to do is to pinch your nose gently and swallow at the same time.

TIP: You can practice the Toynbee maneuver in front of a mirror to watch the muscles in your throat working to equalize.

When you swallow, your Eustachian tubes will open, and the movement of your tongue, when your nose is blocked, will compress air which passes through the tubes to the middle ear. This will equalize the dead air space in your middle ears.

The Toynbee maneuver is widely known to be safer than the Valsalva maneuver, which involves pinching your nose and blowing against it. This is because when you swallow, during the Toynbee maneuver, you are actually opening the normally closed Eustachian tubes by utilizing the muscles of the throat to open the tubes. When your soft palate muscles pull open the tubes, the air from your throat travels up to your middle ears to equalize the pressure. The Valsalva maneuver, on the other hand, does not activate these muscles but forces air from the throat into the Eustachian tubes which can cause damage if done incorrectly.

Read More: The Different Ways to Equalize Your Ears

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Why Do We Equalize?

So we know we need to equalize our middle air space in our ears to avoid barotrauma, but in what situations do we need to equalize our ears using the Toynbee maneuver?

We usually equalize our ears constantly without realizing it when we swallow. However, it is more noticeable when the surrounding pressure changes quickly, such as when:

• You go up and down in an aircraft
• You go underwater; scuba diving, freediving, and spearfishing
• During skydiving
• In fast ascents or descents in an elevator

Equalize in Diving

The pressure change is highly noticeable when you go diving. This is because water is much denser and heavier than air. This pressure will be felt when you descend underwater and you will need to continue equalizing as you descend.

The volume of the dead air space in your middle ear changes according to your depth. According to Boyle’s Law, the pressure change is greatest at shallower depths and decreases as you go deeper which you can see by the volume. This means you will need to equalize more often at the start of your descent, and less frequently as you get to a deeper depth.

Read More: Can You Go Scuba Diving After Perforating Your Eardrum?

How to Equalize Ears Using the Toynbee Maneuver

Now that you know how to utilize the Toynbee maneuver, you should be doing so frequently when you descend during a dive. Many diving agencies recommend equalizing every 2 feet or 1/2 meter as you descend, however, everybody is different so you can equalize more often if required. You can also pre-equalize by using the Toynbee maneuver on the surface just before you descend. This will warm up the muscles used in the maneuver and make it easier to equalize.