Valsalva Maneuver -- am I doing it right? What does it feel/sound like?
June 9, 2017 2:13 PM   Subscribe

In late April, the clinic told me that the rumbling sound I frequently got in my left ear was caused by a retracted eardrum, and that the retracted eardrum was caused by a blocked Eustachian tube. (There was no sign of infection.) I was told to take Flonase to help clear the Eustachian tube, and also to do the Valsalva maneuver. I know that the Valsalva maneuver is "close your nose and mouth and exhale until your ears pop." But what exactly does that feel like or sound like? How hard to I push?

When I try it, the sounds are typically like the (soft) crackling and popping sounds I hear when I yawn. I don't feel like there is pressure spreading from my nose or throat and toward my ears. Instead it feels like there is pressure building up inside the ear, and just staying there.

I'm afraid to push very hard, out of fear that I'll damage my ears, but I don't know if that's what I need to do. I've had singing lessons, so I can exhale really hard if I try.

I'll see a professional again if this isn't fixed by the time my 2 month supply of Flonase runs out. (The rumbling is less frequent and less loud, but hasn't gone away. The Flonase really helps clear the tubes, by the way.) Before I do that, I want to hear from people who have used the Valsalva maneuver. What does it sound like? What does it feel like? How do I know how hard to push?
posted by CrunchyFrog to Health & Fitness (7 answers total) 3 users marked this as a favorite
I am a pro at this! I have actually found that for my plugged eustachian tubes it's almost better to do something like this. So don't go out and get a balloon but do something that is sort of amended. Hold one nostril closed and sort of hold your finger over the other one but not firmly. So one is closed and one is mostly-closed. Then blow out. I've found that helps clear up your eustachian tubs better that the Valsalva.

What it feels like to me is that there's sort of a bubble of air that scoots up my eustachian tube (i.e. more or less from nose to ear) and sometimes a squeaking or cracking sound. Or sometimes I'm just clogged up in the head and it sounds like nothing. Over time, I've gotten better at being able t sort of move my ears to help with stuffiness (yawning, chewing gum, etc) but I've also found that SUDAFED (the real stuff) can also help with congestion.
posted by jessamyn at 2:55 PM on June 9, 2017

Yeah, the Valsalva maneuver can be tough to wrap your mind around until it actually just happens. I had to do it again to think of what the tiny little steps are, but maybe this might help:

(1) pinch your nose closed with one hand
(2) keep your mouth closed
(3) pretend like you're blowing your nose (gently) into the hand you're pinching your nose with
(4) you should hopefully (at the very least) feel a release in your inner ear, and maybe "hear" a pop

That's what it feels and sounds like for me. Maybe for others it's different. Hope this helps and you feel better soon!
posted by strelitzia at 2:55 PM on June 9, 2017

Scuba divers do this as they are descending to allow their ears to equalize. It almost NEVER works for me, I have narrow eustachion tubes, which makes them block up easier. You shouldn't have to push very hard at all, if it's going to work. Strelitzia has the description right.

When it works, it sounds like you'd expect it to sound - a little "crackle-squeak-whoosh" in your ears. It sometimes is the same sound that happens when you fly in a plane and your ears "pop" - the one when you're landing, rather than taking off. Or sometimes it adds in the "squeak-whoosh" part.

Don't blow very hard against a closed nose and mouth. Don't blow as hard as you would have to blow on a normal sized balloon. Maybe as hard as you would blow on a water balloon sized balloon?

Some people I know use over the counter decongestant (the pseudoephedrine kind, however you spell that, not the phenylephrine kind) to help those eustachion tubes stay nice and liquid, and easier to clear. It looks like Flonase is a steroid and decongestant. You can get the same decongestant effect with any OOC brand when your Flonase prescription runs out.
posted by bluesky78987 at 4:23 PM on June 9, 2017 [1 favorite]

You shouldn't need to push that hard. In my experience you literally feel a pop in your ear. Like it is a bigger pop feeling than the crackles you get from yawning or swallowing. Then I hear a kind of whooshing, like all the background noise that I've been hearing is rushing in. That's not what it is but it's how it feels.

Whenever I do this, my ear ends up feeling more clogged afterward forwhatever reason. The best ear pops I've ever gotten have been from my neti pot. Not sure if this is something you've tried but if it isn't, it may be worth adding on. My sinuses are a hot mess and I have a retracted ear drum. I'm currently using a neti pot, flonase, and astelin nasal spray, and.... my ears are still clogged. But they're popping a lot more, so hopefully we're getting there!
posted by Amy93 at 6:43 PM on June 9, 2017

I use a variation of this, in that I hold my nose, close my mouth, and hold one ear closed. Then blow gently. The opposite ear makes a pop/whoosh. Repeat on other side. Not sure where I learned this, but it works on my headcolds.
posted by Crystal Fox at 9:53 PM on June 9, 2017

A Dr told me that the Valsalva maneuver "close your nose and mouth and exhale until your ears pop" is out-dated and no longer being recommended to patients, because it can lead to burst eardrums that require surgery.

This is especially likely if there is mucus or inflammation blocking your sinuses/ Eustachian tubes, e.g. you have a cold or allergies.

The Dr told me this after *I* had burst my eardrum doing the Valsalva maneuver. I had to be referred to an ENT Dr.

So, please reconsider.
posted by Murderbot at 10:34 PM on June 9, 2017 [1 favorite]

When I try it, the sounds are typically like the (soft) crackling and popping sounds I hear when I yawn. I don't feel like there is pressure spreading from my nose or throat and toward my ears. Instead it feels like there is pressure building up inside the ear, and just staying there.

This sounds to me like your Eustachian tube is not just clear, but actually open.

Which is a recognized though rare condition -- patent (or patulous) Eustachian tube -- and interestingly enough is often misdiagnosed as a congested Eustachian tube:
Upon examination of a suspected case of patulous Eustachian tube, a doctor can directly view the tympanic membrane with a light and observe that it vibrates with every breath taken by the patient. A tympanogram may also help with the diagnosis. Patulous Eustachian tube is likely if brisk inspiration causes a significant pressure shift.

Patulous Eustachian tube is frequently misdiagnosed as standard congestion due to the similarity in symptoms and rarity of the disorder. Audiologists are more likely to recognize the disorder, usually with tympanometry or nasally delivered masking noise during a hearing assessment, which is highly sensitive to this condition.[3]

When misdiagnosis occurs, a decongestant medication is sometimes prescribed. This type of medication aggravates the condition, as the Eustachian tube relies on sticky fluids to keep closed and the drying effect of a decongestant would make it even more likely to remain open and cause symptoms.
The misdiagnosed patient may also have tubes surgically inserted into the eardrum, which increases the risk of ear infection and will not alleviate patulous Eustachian tube. If these treatments are tried and failed, and the doctor is not aware of the actual condition, the symptoms may even be classified as psychological. [emphasis added]
posted by jamjam at 7:36 PM on June 10, 2017 [1 favorite]

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