How to Do Hands-Free Equalization (BTV/VTO)

hands-free equalization

The hands-free equalization technique, also known as BTV (béance tubaire volontaire) or VTO (voluntary tubal opening) in English, is a very useful but optional technique one can add to their repertoire in order to become a better freediver.

Some people are already capable of hands-free equalizing,  but not at a level adequate for equalizing during freediving. For instance, if you are able to go up a mountain or fly on an airplane without feeling the increasing pain in your ears due to the changes in pressure (without resorting to the popular pinch-and-blow Valsalva maneuver), then you have figured out how to open up your Eustachian tubes without help from your hands.

The difference between hands-free equalizing during a flight, and dozens of meters underwater, is that the water pressure is much greater and occurs more rapidly due to the speed at which you descend. This makes the VTO technique more complicated than opening one’s Eustachian tubes mid-flight. With that said, by learning about the VTO maneuver, you will be able to more reliably open those tubes without any assistance from your hands.

Why Learn Hands-Free Equalization?

There are three main reasons to learn hands-free equalization:

  1. It is known to be the least risky and efficient equalization method, which means you can most likely dive deeper while staying more relaxed.
  2. Since you don’t have to use your hands to pinch your nose, you can instead use them for other activities like spearfishing or underwater photography.
  3. The hands-free method, out of all the methods, resembles what the body naturally does daily, such as swallowing, yawning, and burping. Despite these actions being done involuntarily, you can learn how to train these muscles to activate at will.

If you are an experienced freediver who has already reached great depths without hands-free, you may find that you can dive deeper by doing hands-free equalization. Furthermore, these techniques can also be applied to your mouthfill while wearing a mask.

Getting Started

Before we get started with hands-free training, you must first understand that successful equalization follows a two-step process. There is an air shift phase and equalization phase. Most guides and instructors only focus on the equalization part due to their complexity, but not so much on the air shift. Unfortunately, this results in many beginners not realizing that they are using air from their lungs to equalize.

What is air shift? It is when one shifts the air from their lungs to their mouth. One can perform an air shift with various methods, such as reverse packing or with abdominal contractions. Furthermore, one can bring up small or large amounts of air, depending on their preference. For instance, a small amount may be all that’s needed for the Frenzel maneuver, whereas advanced freedivers prefer bringing up a large amount to perform a mouthfill.

Regardless of which equalization method you prefer, the air shift is necessary since bringing air from the lungs into the middle ear is what compensates for the compressed air in the middle ear. No matter how you equalize, the goal is to open up the Eustachian tubes so that air can pass through.

A successful equalization cycle will combine both the equalization technique and air shift to pull off. There is more than one way to air shift, as mentioned above. You can decide to do one large charge (shifting the air from the lungs to the mouth) and numerous equalizations in a row before doing another charge.

Or you may prefer to do one small charge for each equalization. Or one can try to do the largest charge they can, filling their mouth to the limit with air, and using this stored air for as many equalizations as possible (in other words, this is the mouthfill method).

Whether you are learning hands-free equalization or any other method, you must get comfortable with air shift in addition to the hands-free method itself. Perhaps the reason why so many fail to learn hands-free is because they focus all of their efforts on the equalization technique, but not the air shift portion.

Equalization and air shift are two sides of the coin. You cannot simply pick one and not have the other. That is why many only seem to be able to do hands-free on land, but they struggle to do it underwater.

What’s Going On When You Hands-Free Equalize?

Knowing what’s going on in your body will make it easier to understand the process of hands-free equalization. First, understand there is something called the Eustachian tube which connects the middle ears to your nasal and oral cavities. In other words, this tube is the link between your ears and your mouth and nose, and by extension your lungs. The goal is to get air from your lungs to your middle ear to equalize the pressure there.

Seems straightforward right? The problem is that the Eustachian tubes are closed at rest. This is necessary to protect the ears from infection and foreign materials. However, they open up whenever we chew, swallow, talk, burp, or yawn in order to regulate pressure and get rid of waste from the middle ear. This happens naturally, and most people cannot voluntarily open the Eustachian tube unless they train for it.

Hands-Free Equalization Exercises

We are going to focus on three exercises. The first exercise will show you how to open your Eustachian tubes. The second will show you how to equalize your dive mask. The last exercise is a combination of the first two. Putting everything together, what you should do while in the water is to equalize your mask and then open your Eustachian tubes.

Exercise 1 – Opening the Eustachian Tubes

Begin by pinching your nose and then sucking air out of your middle ears by swallowing. Your eardrums should feel like they moved towards you, similar to the feeling as you descend underwater. This is the opposite of equalization; you are temporarily removing the air from your ears.

At this point, your ears will feel like they are blocked and you may feel slightly uncomfortable. Feel free to release this pressure by yawning. Elongate the space between the floor and roof of your mouth. Do many variations of yawning. Play around and exaggerate the action. You can also try swallowing in various ways too.

For instance, you can try stretching out the space next to the sides of your mouth as if your ears were being pulled very hard. You can also try wiggling your ears or moving your jaw side to side, or even do a Frenzel maneuver.

The point of all of these seemingly pointless movements is to experiment with unblocking your ears and reverting the eardrums back to their original position. Right now, most of your attempts have probably ended in failure. It may take you ten tries before you succeed once.

By experimenting with different ways of yawning or swallowing, you will eventually find a movement that can reliably unblock your ears. Instead of a 10% success rate, perhaps you can increase that to 30 to 50%. The goal is to figure out which movement works best with your body and increase that success rate to 100%.

So pretend you’re a kid again who is trying to unlock the mysteries to freediving success. Once you find a movement that you like with a moderate chance of success, keep practicing it everyday. Memorize how to perform that movement until it becomes second nature. You need to be able to do it even when under pressure (literally) to successfully equalize your ears.

Exercise 2 – Equalizing the Mask

Without exhaling or inhaling any additional air, start grabbing balls of air and continuously spitting them out. This shouldn’t be too difficult, and it may feel like you can do it indefinitely. The next step is to spit this air out through your nose instead. You can try using your tongue to extract air from your mouth and vent it out your nose like a classic reverse packing movement.

If you’re not sure whether you’re doing it correctly or not, lightly press on your nose and feel the puffs of air leaving your nose as you do this exercise. Your belly should not move while performing this movement.

To make this more interesting, treat it like a game. As you’re spitting the air through your nose while holding your breath, count how long you can do it for and how many spits you can do. Spit at a rhythm to mimic depth. Try spitting a ball in one second intervals.

Try to spit out different sizes. Move your tongue all the way down to collect a large blob of air and spit it out through your nose while imagining your mask loosening from the pressure getting equalized. Not spit a small one and picture the mask moving only slightly.

If you struggle to reverse pack, instead try exhaling out. Keep on exhaling mini puffs of air through your nose. After a small exhale, relax your belly, then perform another. Keep doing this. Essentially, you are doing an air shift with abdominal contractions.

Another way to perform an air shift with abdominal contractions is by doing a Grouper Call. Make a humming sound and feel your mouth expanding like a balloon. Afterwards, remember to relax your belly.

Regardless of whether you equalize the mask through exhaling or reverse packing, air should be consistently flowing in one direction from the lungs to your mouth, past the soft palate and through your nose. It should not return to your lungs because the glottis will be constantly closing.

Exercise 3 – Mimicking the Descent

By combining exercise 1 and 2, we can mimic what it is like to descend in the water. Start by exhaling some air out of your nose (exercise 2) and then perform one hands-free equalization (exercise 1). Next, try one spit and two hands-free equalizations. Next, try one spit and perform three hands-free equalizations, and so on.

Keep repeating this until you run out of breath. This is similar to what you will be doing during an actual dive. It is not only a fun training method to practice equalization, but it can train your breath-hold. You need to practice this so that you can consistently move air from your lungs into your mouth and equalize while carbon dioxide levels keep increasing.

Practicing in the Water

Once you have performed all of the exercises on land and feel confident that you can translate it into the open water, then let’s head there. You should start with free immersion since it is slower paced and gives you the opportunity to grab the line if needed.

Now, do your breathe-up and enter the water. Stay calm and relaxed. If you notice any tension, try to relax and let it go. As you descend, you will feel the increasing pressure on your ear drums, similar to the pressure when performing exercise 1. And just like in exercise one, perform the movement to release that pressure.

After a short while, you will feel your mask becoming tighter due to the increasing pressure. Here is where exercise 2 comes in. Do an air shift and move the air into the mask either through abdominal contractions or reverse packing to equalize it.

Essentially, you will keep repeating these two movements. One to release the pressure in your ears, and the other to equalize pressure in the mask. How successful you are at hands-free equalization depends on how well you can perform these two alternating movements.

If you don’t yet have a rhythm down, then try doing one mask equalization to three hands-free equalizations. Adjust this to your preference.

When starting out, you may descend very slowly because of how hard you need to think about each action. The more experience you have, the more automatic each movement becomes until it is simply part of your muscle memory. And the less you need to think, the faster you can get at descending.

What Really Happens When Opening the Eustachian Tubes

The normal ways of opening the Eustachian tubes, such as yawning, isn’t possible while freediving and thus you must find another way to open them. When hands-free equalizing, you must voluntarily contract two muscles near the Eustachian tubes, the soft palate and the tensor veli palatini (TVP), which will open up the Eustachian tubes.

The TVP is a tiny muscle connected to the skull in the soft palate space beside the last molar and on the roof of the mouth.

Some people have been known to activate their TVP unconsciously during an airplane ride, however not everyone is able to manipulate their TVP right off the bat without some guidance. While learning how to voluntarily activate the TVP, you can rely on audible, visual, or tactile cues to get a clearer view of your uvula.

Furthermore, activating your TVP will stimulate the palatopharyngeal muscle. If done correctly, as the TVP is activated you will be able to see the uvula rising and the larynx (Adam’s apple) closing. You might be able to see the larynx closing from the outside as well.

The Eustachian tubes are normally sealed shut due to their intrinsic elasticity, as well as the pressure exerted by nearby tissues and the tension of the moist mucosa.

Additionally, when activating the TVP, a gentle crackling sound is sometimes heard in the ears like two sticky surfaces being peeled apart. You can even feel the TVP activation with your hands by lightly touching the area beside the last upper molar.

Once you are capable of activating the TVP voluntarily, you should determine if its range of motion and strength is enough to open the Eustachian tubes. To test this, try to hum audibly. What you are looking for is if the sound can pass through the tube opening and fill up your head.

Some adjustments may be needed to create sufficient space for the tubes to remain open. For example, you may need to wiggle the jaw from side to side or protrude it forward slightly to do so.

Training to Open the Eustachian Tubes

Since the average person doesn’t contract their TVP often even out of the water, consistent and diligent practice is necessary to improve the strength and coordination for use during freediving equalization. One should work on their TVP training in equal measure with their diaphragm and shoulder flexibility training. We recommend training every day.

To begin, try to open the tubes by twisting your TVP and test them by humming. If the sound doesn’t fill your head even after you’ve activated the TVP, then the tubes aren’t open. When starting out, you won’t always get it right the first time and it is a part of the learning curve.

Try to wiggle your jaw from side to side or protrude it forward while activating your TVP. You may need some slight pressurization to help the tube open up. You can do this by pinching your nose and using the Frenzel maneuver to equalize, then holding for 15-20 seconds.

Repeat this 3-5 times to relax the muscles surrounding the tube. Once you have managed to open your Eustachian tubes and can hear the humming fill up your head, it’s time to begin working on coordination training by opening the tube for numerous repetitions. Try to progress all the way up to 300 repetitions. That sounds like a huge number, but it’s really equivalent to a few hours of freediving and can be done within five to ten minutes while training.

How strong one’s TVP is will determine how great of a depth that they can continue to open their tube against the increasing water pressure, which squeezes the Eustachian tubes tightly and makes them difficult to open. Challenge yourself to keep your tubes open for progressively longer periods of time

BTV/VTO Maneuver

The VTO maneuver is basically a variation of the popular Frenzel maneuver, supported by the voluntary opening of the Eustachian tubes. One must have a firm grasp of the Frenzel Maneuver if they wish to successfully deep dive with VTO. Thus, if you are not comfortable with the Frenzel maneuver, stop and learn that first. You will not be able to perform the VTO without it.

When equalizing with the Frenzel maneuver, the result is that the air is pushed through the closed Eustachian tube to open it, similar to how a bent garden hose can be straightened if sufficient water pressure builds up and pushes through.

The VTO maneuver supports the Frenzel maneuver by voluntarily opening the tubes and not relying on extreme pressure to push the air through to the middle ear. Thus, it is not necessary to pinch the nose for this technique.

To perform the VTO maneuver, do the following steps:

  1. While wearing a mask, put the tip of your tongue behind your front teeth and make a small ball of air above the tongue.
  2. Close your throat and lower the soft palate.
  3. Simultaneously pull the tube open and push the air back and up. Think swallowing while yawning.

VTO Maneuver Exercises

You should first practice VTO on dry land before testing it in the water. Wear your dive mask and make sure the mask strap forms a watertight seal. Even on dry land, you want to make your training as close to the real thing as possible.

After you establish the muscle memory to do this maneuver, then you can think about trying it in the pool. Start in the shallow end with your head facing forward and lowering it only a few feet underwater. When this gets easier, move to a deeper area of the pool but maintain the vertical head-up position while training.

Once the deeper end of the pool is no longer a challenge, it’s time to take your practice to the open water line. Practice doing head-up pull downs to see how well you can perform VTO at depths slightly deeper than the deep end of the pool. No need to go down too far, staying within the 10-15m range is adequate at this stage of your training.

As soon as you are confident with the head-up VTO training, the next thing to practice is doing VTO in a prone position (face down). Practicing this in a pool while wearing a weight belt to keep you negatively buoyant allows you to enjoy a nice, slow descent so that all your mind needs to focus on is perfecting the technique and monitoring your body’s feedback.

Progress only when you feel comfortable and perform consistently well. You can add even more weight to the belt to increase the descent speed while maintaining a prone position. Gradually increasing the speed while prone based on how comfortable you are with your technique can help you train the muscle coordination and timing for equalizing with VTO.

Once you are more proficient in the prone VTO technique, the next step is to try VTO in an angled descent, and eventually in a proper head-down descent as you would be when freediving. It may be helpful to try hanging upside-down on dry land first to get accustomed to the discomfort of the blood rushing to the head before trying it underwater.

Just like in the other exercises, start with a gradual and controlled descent and slowly increase the depth and speed that you are willing to reach. The key is to progress at a comfortable pace instead of rushing it.

Common Issues with Hands-Free Equalization

In order to successfully hands-free equalize during a dive, three criteria must be satisfied:

  1. The glottis must be closed.
  2. The soft palate must remain neutral so that the air can pass through to the Eustachian tubes.
  3. The Eustachian tubes must be open.

If you experience difficulties, then most likely at least one of the three factors listed above is not being met. From here, you must ask yourself some questions to help you figure out the problem.

Are you relaxed?

Being stressed out or nervous will cause your muscles to be more tense than normal, and this can negatively impact the hands-free method. So look for any unwanted tension and try to release it. In order to remain calm, do every step slowly and methodically.

When learning a new technique, you should be as introspective as possible and make mental notes of what went right, what went wrong, so that you can look up the solution and do better next dive. To do this successfully, don’t be too hard on yourself and give yourself time to learn and improve.

Keep repeating a step that you are struggling with. Don’t get impatient and move on before you’ve mastered it. You must reach a level where you can dive and be conscious of what’s going on with your body at each step of the process, particularly with the glottis, soft palate, and mask space. Going too quickly will cause you to get overwhelmed and lead to panic.

Open glottis

If your glottis is open, it will cause the air in your mouth to move into your lungs. This is called “swallowing” and it is a common mistake. Generally, if you feel the mask is starting to dig into your face from the pressure, then it means your glottis is open.

Also, keep an eye out for any leaks in your masks when your body is experiencing contractions. Some freedivers have difficulty keeping their glottis closed when they experience a contraction. If this happens to you, try to tuck your chin in to lessen the impact and work on getting better control of your throat.

Closed soft palate

A closed soft palate will prevent the air in your mouth from entering your nose and ears. Since the Eustachian tubes are located in the nasal cavity above the soft palate, in order to successfully equalize the soft palate must remain neutral so that air can transfer from the mouth to the middle ear.

If the soft palate is either closed upwards or downwards instead of in the neutral position, you will feel a blockage and fail to equalize.

Can Everyone Do Hands-Free Equalization?

The VTO method is very difficult to teach according to various experts, and how well one can reliably perform it depends on the shape of their Eustachian tubes. It is estimated that only 30% of divers have successfully learned how to perform VTO even after receiving personal instruction. Some experts are so pessimistic, they believe that VTO cannot be learned even through training, and that only those with favorably shaped Eustachian tubes can succeed.

Despite how few people can do VTO, experts at least agree that it is one of the safest equalization maneuvers, and since it is completely hands-free, it can help the diver conserve energy and will not impede their movement.

Regardless of whether one has successfully managed to learn VTO or not, the training exercises will strengthen the muscles that hold open the Eustachian tubes, which is beneficial for all divers regardless of which equalization technique they prefer. Learning how to activate these muscles to loosen up the Eustachian tube opening when equalizing means less force is necessary to successfully equalize.

Benefits of Learning Hands-Free Equalization

Judging by how long this article is getting, learning hands-free equalization will certainly take some hard work. Is it really worth investing all of this time to learn something so complicated? Will mastering this technique all of a sudden make you into a top freediver? In this section, we will go over the main advantages of hands-free equalization in great detail.

Gives you a buffer when wearing a mask

You can choose to dive with a nose clip or with a mask. With hands-free, wearing a mask is beneficial because the air from your mask can act as a buffer in case you forget to do an equalization.

The lingering oxygenated air will help you catch your rhythm and get back to equalizing. Those who prefer a nose clip will have to turn back if they ever forget an equalization.

Many people see the mask as a hindrance, but to those who do hands-free equalization, it is an extension of their nasal space. As such, freedivers can factor this extra space into their air management and intentionally put air into the mask during the initial descent and inhale it back as the air expands during the ascent.

Freedivers who do this often excel at pulling air into their mouth and some may not even need to pack or rely on a nose clip to reach the same depths as those who Frenzel.

Alternative to Frenzel Method

The hands-free method is another option for those who cannot do Frenzel for some reason. Perhaps you are too used to doing the Valsalva and have ingrained certain patterns that are hard to unlearn, and thus you would rather just learn an entirely different method to help you reach depth.

With that said, you can always learn the Frenzel method in the future after learning how to do hands-free. However, if you manage to learn hands-free, then the idea of going back to a more energy-consuming method will not seem as appealing. However, if you want to be an all-around great freediver, it doesn’t hurt to be well-versed in more than one equalization method.

Disadvantages of Hands-Free Equalization

There are a couple of downsides that I’ve found when doing hands-free.

Extreme Sensitivity to Pressure

Since this method is so reliant on sensitivity to pressure for performance, I’ve had some terrible experiences with some mild middle ear squeezes.

In my experience, if I have an ear strain on an eardrum that causes it to be more sensitive than the other, it complicates my dive. The less sensitive eardrum will feel fine but the other one will feel extremely sensitive to the pressure and force me to equalize just for that one ear.

Where Frenzel Outshines Hands-Free

Hands-free relies on creating a negative pressure that has to be released. On the other hand, Frenzel works by inducing a positive pressure that is naturally neutralized as one descends. As a result of this preemptive pressure difference that acts as a natural protection against the increasing pressure, some may find it more comforting to use.

Frenzel, when done on time, will not allow one’s ear drums to stretch further than the neutral position, which is one aspect in which Frenzel outshines hands-free.

How Deep Can You Equalize with Hands-Free?

The deeper one dives, the greater the water pressure squeezes on the body, which makes it difficult to force air through the tightly compressed Eustachian tubes. If the depth limit is not very deep, then it begs the question “why learn it at all?”

By looking at people’s answers online (and people never lie on the internet, right?) figures ranging from 20-50m have been given. From this, we can average the number out to 35m for hands-free equalization using the VTO method. For many, reaching a depth of 35m is already impressive, and there may be no need to learn additional techniques to dive further.

So if you are comfortable with the VTO method of equalization, you may be able to continuously equalize until around 30m, where the water pressure may make it too difficult to continue using hands-free methods. Those who want to push beyond should try combining the hands-free method with the Frenzel maneuver.

With that said, it’s not like there is any data that confirms there is an arbitrary depth limitation for the hands-free equalization method. Perhaps a few years from now, someone will shatter all of the preconceived notions regarding the limitations of hands-free. After all, it is an equalization method like any other, so theoretically the only limit is one’s ability to hold air in their mouth after an air shift, their ability to air shift despite the water pressure, and their hypoxic limit.

Dive Masks and Hands-Free Equalization

Dive masks are often seen as a hindrance by many freedivers. To them, it is another place where they must waste precious oxygen to equalize, otherwise the increasing pressure will damage their eyes.

However, for hands-free equalization, wearing a mask and equalizing should not be seen as an issue. Top freedivers who use hands-free reach depth with their mask without being in extreme pain. How is this possible?

The difference is in how air is managed with the hands-free method and the Frenzel method. With hands-free, the mask will always be equalized since the mask is treated like an extension of the nasal space. With Frenzel, the constant pinching of the nose causes the mask space to be isolated from the nasal space, resulting in a pressure difference.

As a result, those who practice hands-free do not see the mask as a hindrance. In fact, the mask is necessary since the air in the mask will equalize the middle ears. On the other hand, someone who Frenzels must deal with the mask pressure separately by exhaling some air to prevent the mask squeeze.

Thus, those who use the Frenzel method often view the mask as a waste of precious oxygen, and they find it liberating when they switch to using a nose-clip as they dive deeper.

As an aside, you may think that you are wasting precious oxygenated air when putting so much of it into the mask during the initial descent. However, towards the tail end of the dive when you are most hypoxic, you can inhale this relatively oxygenated air. Remember, in hands-free the mask is basically an extension of the nasal space.

No air is ever “wasted”, and in fact this extra bit of air may be what gives you the last remaining bit of energy to push through to the surface. Regardless of whether you prefer Frenzel or hands-free, the next time you dive try inhaling some of this air and see how it makes you feel.

Tips to Keep in Mind

Don’t feel bad if you feel like you haven’t made much progress even after a few days of training. Learning VTO for some can take weeks and even months for some. For a lucky few who naturally have good control over the muscles surrounding their Eustachian tubes, perhaps only a few hours of training is needed.

Divers are also faced with anatomical and physiological differences. However, those who have already been equalizing the pressure in their ears on airplanes without using their hands are already several steps ahead and it is only a matter of some training before succeeding with VTO.

For the rest, being warmed up and properly hydrated prior to training is a must. A simple trick is to chew gum for 5-10 minutes prior to the exercises or a dive session to warm up the jaw muscles and increase blood flow to the critical areas needed to equalize. Insufficient hydration will only result in sticky membranes covering your Eustachian tubes and nasal passages.

When performing VTO, keep in mind that since it uses less pressure to equalize than Frenzel, once the Eustachian tubes are squeezed tightly by water pressure, it becomes very difficult to open up again. Thus, this results in another skill that may need to be developed: a higher equalization frequency than Frenzel.


While many have failed to learn how to hands-free equalize, that doesn’t mean it is impossible. It’s a technique you can learn just like Mouthfill or Frenzel. Depending on your freediving experience and unique anatomy, learning one equalization method may be easier for you than another.

However, as long as you maintain good awareness, practice diligently with the recommended exercises, and give yourself sufficient time, then you can learn any equalization method you wish. Be prepared to work harder than others if it doesn’t come naturally to you.

Lastly, no matter what equalization method you prefer, you must never subject your ears to the pain of the increasing pressure! Should you fail to equalize, consider the dive a failure and just head back to the surface! Do not try to salvage a dive where you cannot equalize. It’s not worth the risk just to get a silly certificate or place higher on a competition.