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A little background:

I was practicing with my instructor one morning. It was just him and me and we were doing free training of submission grappling. At one point I managed to get him in a choke hold and I expected him either to break free or to tap out. When I looked down at him his eyes were rolled back and only partially opened. I released him and he lay there gasping for a moment. I asked him if he was alright and he kind of blinked a few times and said "Of course I'm alright, why do you ask?" I replied "Because you appeared to be dying." None of his students had ever beaten him before in submission grappling. He told me later that he thought to himself "this is a tight choke, I should consider tapping out" and then he saw himself running through a meadow, without a care in the world.

It kind of freaked me out a little, because we were the only two people there, and I wasn't sure what I would have needed to do if he hadn't immediately woken up (other than call 911). I know some schools make a point of choking their students unconscious at least once, so they know what it feels like. Personally that has always struck me as unnecessary.

What kind of dangers are there in choking someone (or being choked) to the point of unconsciousness?

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A well performed martial arts choke should result in unconsciousness within 3-5 seconds, so I'm not sure that the distinction between A and B is legitimate. –  Mark C. Wallace Sep 14 '12 at 11:48
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When we teach chokes, we also teach a method to revive some one from choke. Please get training in this from someone qualified before trying it, but loosely speaking we seat the person on the floor, kneel behind them with a knee bracking their spine and gently pull the arms back to expand the chest. That isn't directly responsive to your question, but I'd want to know it if I were in your situation. –  Mark C. Wallace Nov 6 '12 at 13:47
    
Here's a case where someone familiar with jiujitsu was choked, but not choked unconscious, the choke "felt different", and had a stroke three weeks later that he blames on that choke. If this were prevalent it would be worrying, but it seems more like a less-common relative of commotio cordis, which is a pre-existing condition combined with normal athletic activity, which together causes death. –  Dave Liepmann Nov 27 '12 at 3:21
    
It's just plain bad practice to teach someone how to do a choke, and be practicing chokes, without knowing how to resuscitate someone that's unconscious. –  user878 Dec 30 '12 at 4:49

12 Answers 12

up vote 27 down vote accepted

Cutting off cerebral blood flow (CBF) to the brain via a blood choke can be very dangerous and should not be conducted in a training session. Properly 'tapping out' is vital when practicing choke. Windpipe (air) chokes involve compressing the trachea which as stated above derive the entire body of air this should also not be done in training under normal conditions as it can cause tissue damage and long term health issues.

Brain tissue can be damage or die completely if CBF is partially or completely occluded causing ischemia. Although the person should pass out before damage occurs there could be underlying health concerns that may cause issues.

When practicing BJJ I always tap out before passing out, just ensuing there is necessary tightness. Personally even under training condition's with supervision and the person releasing right away I still would not want it to get to the passing out point.

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-1, the first paragraph is unsupported by anecdote or data. Cutting off cerebral blood flow via blood choke is exactly what millions of judo, BJJ, SAMBO, and submission grappling exponents practice extensively every day without the ill effects you claim. –  Dave Liepmann Sep 27 '12 at 21:04
    
-1 For the first paragraph. Show some data for that. Cutting of the blood flow for a few seconds won't do any kind of damage as brain damage usually starts occurring withing few minutes of unconsciousnes and a few seconds is definetly not minutes. –  Christian May 24 at 18:19

Worth making the distinction between a blood choke and a air choke. ie, are you cutting off the air ( through the throat) or the blood (through the arteries).

Throat choking is a lot more dangerous because of the damage you can do to the actual throat. Can cause swelling, etc and can cause people to die some time later.

Blood chokes, less dangerous, but can still cause problems for people who are predisposed to various conditions.

Similar kinds of risk as being hit in the head. Things can go wrong. Its worth knowing the first aide responses to the likely scenarios you might find yourself in.

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I have only ever learned blood (artery) chokes. –  Jack B Nimble Jan 31 '12 at 22:58
    
@JackBNimble Some forms of hadaka-jime (judo) and the guillotine (BJJ) can attack the trachea. –  Dave Liepmann Apr 27 '12 at 20:23
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poorly performed cross chokes or kata juji jime can also attack the trachea. –  Patricia Apr 30 '12 at 15:56
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Realistically you're usually going to be doing both if you're going for a blood choke. It's pretty hard to not also restrict airflow. –  Robin Ashe Jul 3 '12 at 22:27
    
My dojo includes a number of physicians; they claim they can see the results of a blood choke on a brain scan. Both are quite dangerous. We haven't trained choke in quite a while, but I don't remember it affecting the trachea - I think I was breathing throughout. –  Mark C. Wallace Sep 14 '12 at 11:50

There are two types of chokes: a blood choke, in which blood flow to the brain is, at least temporarily, halted; and an air choke, in which compression to the trachea or chest stop airflow into the body, and thus oxygenation of the blood.

Both are inherently dangerous. During an air choke, excessive pressure can lead to the collapsing of the trachea or lungs, making it impossible for the victim to draw breath. Treatment for this is dependent upon the cause: a tracheotomy (in the case of a collapsed trachea) or chest tube (in the case of pneumothorax) may be required to reestablish breathing.

Blood chokes, on the other hand, can in rare cases lead to the collapsing of arteries. One theory is that compression of the carotid artery, in addition to causing cerebral anoxia, also sends a signal via the vagus nerve to the heart, which can cause arrhythmia or reduce bloodflow further to as low as 1/3 normal volume.

However, it should be noted that the greatest threat, cerebral anoxia, causes brain cell death after 4 to 6 sustained minutes. All other dangers are minute in comparison, and odds are against long term damage or death. That said, it's worth remembering that even a simple hematoma (bruise) can cause death (a clot can break away and cause a stroke or heart attack or other infarction), and training in any sort of martial art should be treated with the respect it deserves.

Edit

It should be noted that the dangers inherent in martial arts chokes are also similar to those of breath-play in the S&M community. In an article by Jay Wiseman, who is, in his own words:

I was an ambulance crewman for over eight years. I attended medical school for three years, and passed my four-year boards, (then ran out of money). I am a former member of the American Academy of Family Physicians and a former American Heart Association instructor in Advanced Cardiac Life Support. I have an extensive martial arts background that includes a first-degree black belt in Tae Kwon Do. My martial arts training included several months of judo that involved both my choking and being choked.

A simple rundown is this:

The primary danger of suffocation play is that it is not a condition that gets worse over time (regarding the heart, anyway, it does get worse over time regarding the brain). Rather, what happens is that the more the play is prolonged, the greater the odds that a cardiac arrest will occur. Sometimes even one minute of suffocation can cause this; sometimes even less.

So why can this happen? When denied oxygen, the heart contracts at multiple sites, usually in the ventricular region (causing "premature ventricular contractions" or PVCs). In the event that a PVC occurs during a phase in which ventricular depolarization is occurring (called PVC-on-T or R-on-T), then ventricular fibrillation (a form of cardiac arrest) can occur. The more PVCs occur, the higher a likelihood of an R-on-T event, and thus the higher a likelihood that event will trigger cardiac arrest.

Secondarily (and briefly, since detail is gone into in the article), the build up of CO2 in the blood stream will cause a dissociation in existing H2CO3 (carbonic acid, an equilibrium of H2O and CO2) into HCO3- (bicarbonate) and H+ (an acidic Hydrogen ion). This build-up of acid can shift the pH lower. Since both the increase of blood carbon-dioxide and decrease of blood oxygen lower the pH, the effects of suffocation can cause the pH to plummet. pH levels below 6.9 or above 7.8 are considered incompatible with human life.

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+1 for the only answer that provides the correct information from the dangers of blood choking. Being out for a few seconds shouldn't do any real harm except a headache. 4-6 minutes, that's another story. –  Christian May 24 at 18:23

The only answer that can be given is that it is very dangerous. The reason for this is that everyone has different biological and physical toughness and you, as their opponent, cannot make any valid guess as to how much they can take. (And the truth is that they wouldn't know either if they were honest.)

Back when I was young and stupid, I used to tough out chokes on a regular basis. I look back and cringe at that behaviour. Thankfully, I always erred on the side of caution when attempting such a move on my opponent and would discontinue my attack if I thought they were trying to tough it out themselves. I have been penalised for this in contests, but I'll take the points against me rather than the possibility of a life of regret that I didn't stop sooner.

There's a reason what we do is called "martial" arts. We learn very efficient ways to kill people. With great power comes great responsibility. That's not just a movie quote, it's an honest to goodness fact. Always err on the side of not hurting your opponent.

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"The only answer that can be given is that it is very dangerous" seems unhelpful. For instance, the CDC reports 82 deaths in 12 years among children choking each other for fun (highbeam.com/doc/1G1-176049051.html). An mma doc says it's unlikely. A book says that Judo practitioners, who regularly use chokes, show negligible long-term loss of brain function. So surely there's better answers than just "it is very dangerous." –  khafra Feb 2 '12 at 2:45
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@user249228 The answer isn't unhelpful, it's truthful. The question specifically asked about choking to unconsciousness. Asphyxia is no laughing matter and there is no way to know what someone's physical tolerance for such things would be. Now, under normal circumstances or training regimes, it's a non-issue because everyone (except the young and foolish like I was) taps out before the choke reaches a dangerous point. The question specifically asked about choking to the point of unconsciousness and that is outside of the normal realms that most of us deal with. –  Simon Peter Chappell Feb 3 '12 at 16:20
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I really hope this will be the kind of site where published studies and empirical data are used whenever possible in answers. The martial arts has a terrible reputation for saying "this technique is too deadly to actually gather data on, just trust me." Althought MMA has devolved into a sport, it started as a means of combating this type of epistemic viciousness (artsci.wustl.edu/~grussell/epistemicviciousness.pdf) –  khafra Feb 5 '12 at 13:54
    
@khafra Awesome link, thanks. And good point. –  Dave Liepmann Mar 23 '12 at 19:13

and I expected him either to break free or to tap out. When I looked down at him...

There would have been a physical sign that your instructor had lost consciousness, like his muscles relaxing and possibly a slight change in posture. You need to be considerably more aware than you were. You cannot always rely on your training partner to know when to tap out, as they may try to tough it out and/or not know their own limitations.

You should only be taking your choke holds to this level when you have reached a level of proficiency, and part of that should be knowing how to handle the situation if unfortunate accidents happen.

I know some schools make a point of choking their students unconscious at least once, so they know what it feels like. Personally that has always struck me as unnecessary.

People will have different views on this, but personally I think it is important to know your technique inside out and back to front. Being choked out benefits both participants:

  • the recipient gets to experience the sensation of losing consciousness via the choke, this helps them know their limits, know the power of the technique, and know when they should be submitting
  • the person giving the choke gets to know the stages the recipient will go through as the choke progresses. If you expect to use a potentially dangerous technique like this on a regular occasion (either in training or in the ring) then it is vital you don't over do it and know when to stop despite what your opponent may be indicating to you.
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There is also the concept that in law enforcement, before you are cleared to use less than lethal weapons (mace, tazer) you must first experience what it feels like. This does two things: lessens the likelihood that the weapon will be used inappropriately, and gives the weilder an expectation of what will happen. When done in group sessions, it is likely that you will have someone who isn't affected the same way. For example, some people are simply resistant to capsaicin acid (mace) and merely get angry. Others are reduced to crying heaps on the floor. –  Berin Loritsch Apr 26 '12 at 16:15
    
Of course they don't apply that to requiring them to be shot before using a gun. Given the overuse of tazers, I'd suggest that perhaps having experienced it makes someone more likely to consider it OK. –  Robin Ashe Jul 3 '12 at 22:28

Studies Where We Choked People Unconscious In a Lab

Being choked out might not be good. But we have very little evidence that shows that it's bad to any significant degree, and considerable evidence that being choked out doesn't seem to be of notable danger:

There has been limited medical research regarding neck restraints. One of the first studies was conducted by the United States Military in 1943. A team of American military scientists examined the effect of acute cerebral anoxia —a short and severe lack of oxygen to the brain. To do this, they used an inflatable cervical pressure cuff designed to induce temporary arrest of circulation without affecting the respiratory tract; essentially, a mechanically created carotid pressure hold. The cuff was held down to the lower third of the neck and pressure increased to 600 mm of mercury within one-eighth second. One hundred and twenty six prison volunteers and 11 diagnosed schizophrenic patients were fitted with the cuff which was tightened until unconsciousness was induced. The average time from arrest of cerebral circulation to loss of consciousness was six to eight seconds. The study concluded that arrest of cerebral circulation in normal young men results in fixation of the eyes, tingling, constriction of the visual fields, loss of consciousness, and brief, mild tonic and clonic seizure after restoration of the blood flow. This study, though dated, is perhaps the largest study ever conducted in terms of the sheer number of participants. No deleterious effects were observed from repeated tests on these subjects.

(Source: PDF)

Now, I'm not sure I trust these researchers. (They're in the military, conducting tests on prisoners and mental patients. Perhaps their evaluation of deleterious effects is not, shall we say, the most thorough.) So we have this research, where they arrange an array of sensors to some guys and choke them out:

Is there any danger in the use of shimewaza? This is what a team of experts came together to try to discover. Representing several of Japan's foremost medical schools and universities as well as the Kodokan, this group of medical specialists and ranking educators used the electroencephalograph to detect brain changes; the earoxymeter for blood oxygen saturation, the sphygmomanometer for arterial blood pressure; the plethysmograph peripheral blood vessel reaction and the micropipometer for skin temperature changes. Other studies probed the plasma protein concentration, blood water volume, hematrocrit complete blood count, eosinophil count and urine 17 keto-steroid content.

...

After only 10 seconds of choking, the victims fell unconscious. As soon as they were diagnosed unconscious, the per former released them and, the subjects remained unconscious from 10 to 12 seconds. During this period the victims some times developed clonic, a jerking or fluttering, cramps. All subjects woke up spontaneously.

...

As the subject regained consciousness spontaneously his electroencephalogram readings returned to normal. It should be repeated that in all the cases the performer released his grip immediately after the subjects fell unconscious, thereby limiting the effect of choking to a short period. But had the strangulation continued serious aftereffects would have been expected.

...

The electroencephalograph recorded symptoms very similar to that of a short epileptic seizure.

Those findings sound alarming but not actually dangerous or troubling.

We also have this three-way comparison between judoka (who choke and get choked regularly, though not normally to unconsciousness), boxers (who punch and get punched in the head regularly), and a non-choking, non-punching control group. It's pretty straightforward what they found:

Long-term effects of boxing and judo-choking techniques on brain function.

Author: Rodriguez G , Vitali P , Nobili F

Source: Italian Journal of Neurological Science, 19(6): 367-72 1998

This study shows the relevance of the neurophysiological assessment of athletes engaged in violent sports which can cause brain impairment. In fact, while professional boxers may show brain functional impairment in comparison to normal subjects, judoka do not.

So we see that normal judo practice, which might involve the occasional choke-out, has no evidence of being injurious to brain function in the long term. This is supported by another study where they choked some guys unconscious and looked at their brain waves. Again, the results are not a cause for worry:

Spectral analysis of electroencephalography changes after choking in judo (juji-jime).

Author: Rau R , Raschka C , Brunner K , Banzer W

Source: Med Science Sports Exercise, 30(9): 1356-62 1998

RESULTS: A significant increase of global field power in the delta- and theta-range occurred, while physiological alpha-power decreased. These changes in the low-frequency range reached a statistically significant level within a time span up to 20 s after choking, which was performed at an average choking time of 8 s. In no case did choking provoke neuropsychological symptoms. Yet, spectral EEG-analysis revealed subclinical changes of brain function.

CONCLUSIONS: Choking in judo may induce subclinical electroencephalographic perturbations. The extent and duration can be objectified by means of spectral analysis of EEG data, global field power computation, and brain-mapping representation.

Let me reiterate the non-troublesome aspects of their results: these changes in brain function were neither brain damage nor injury, and the results were less than what a doctor would consider problematic.

Weighing this kind of evidence, the Kodokan issued two warnings, the first of which has good evidence, the second of which seems a reasonable precaution:

To prevent any dangers that may accompany the choke, the Kodokan bulletin advises it is dangerous to perform the choking [both] on subjects with cardiac disorders or those suffering from hypertension since the load to the heart and the rise in blood pressure is marked. It is also advised that it is dangerous for youngsters whose nervous system and heart have not yet attained complete development.

(Source: Ken Endow, DANGER IN THE JUDO CHOKE?) You can see details here in an awful pseudo-PDF format.

Epidemiological-Type Evidence Where We Check How People Turned Out After They Get Choked Out In Training and Competition

If being choked out was known to produce injuries or deaths in training or competition, that sure would be a sign that we shouldn't do it. Yet, judo organizations keep good records, and we find the opposite. A judoka-doctor argues persuasively from empirical evidence that choking someone unconscious in the manner of judo, Brazilian jiu-jitsu or modern no-gi grappling is reasonably safe:

[Choking in judo] is considerably less dangerous than a "knock-out" in boxing and there is no necessity of completely excluding "choking" from Judo, provided necessary precautions are taken.

There are, however, three main dangers of choking based upon the above experiments.

  • To perform a "choking" hold on subjects with cardiac disorders or hypertension.
  • To apply "choking" on youngsters whose central nervous system and heart have not yet attained complete development.
  • To continue to hold after the subject falls unconscious.

Since the advent of Judo, first developed by Professor Jigoro Kano in 1882, no death directly attributed to choking has been reported. There are four main reasons why fatalities do not occur:

  • Choking, whether in practice or competition is supervised and observed by qualified trained instructors and officials.
  • The contestant submits before unconsciousness occurs.
  • After choking the contestant regains consciousness naturally and spontaneously without difficulty in ten to twenty seconds.
  • The immediate application of artificial respiration by the qualified instructor or official prevents prolonged hypoxia.

Choking in Judo is safe because since the advent of Judo statistics show no fatality attributed to the shime-waza. Moreover, scientific studies on choking reveal no deleterious after effects. Finally, the precautionary rules and methods used make the technique of choking a relatively safe means of subduing an opponent in competition.

(Source: E. K. Koiwai, M.D., How Safe is Choking in Judo?)

Our dear doctor goes further, investigating a number of deaths due to law enforcement choking various persons, and finds:

In all 14 cases, this author has noted evidence of injuries to the structures of the neck from bruises, ecchymosis, hemorrhages to fractures of the cartilage of the neck (Cases 1, 5, 10, 13, and 14), and intervertebral discs (Case 7).

He makes the point that these injuries suggest improper application of the choke, such that these should not be considered in the same category as actual judo techniques:

If the carotid artery hold is properly applied, unconsciousness occurs in approximately 10 seconds (8-14 seconds). After release, the subject regains consciousness spontaneously in 10-20 seconds. Neck pressure of 250 mm of Hg or 5 kg of rope tension is required to occlude carotid arteries. The amount of pressure to collapse the airway is six times greater.

(Source: E. K. Koiwai, M.D., Deaths Allegedly Caused by the Use of "Choke Holds" (Shime-Waza))

A Dissenting Case Report

Owens and Ghiadiali present a contradicting possibility. From the abstract:

A case is presented of a patient with signs of anoxic brain damage, with psychometric investigation showing memory disturbance consistent with a left temporal lobe lesion. This patient had been frequently strangled during his career as a judo player; it is suggested that such frequent strangulation was the cause of the damage. Such an observation indicates the need for caution in the use of such techniques.

I do not have access to the full text. It is not clear that judo is well implicated in this case, nor do we know the extent to which this individual was choked out (how often, how long, et cetera), nor can we extrapolate from this one data point. Even being charitable, the conclusion to take from this case would be "don't be choked all the way to unconsciousness, and if you do, don't do it frequently". NB: this is not shown, merely suggested as a cause for further research.

My Tentative Conclusion

There are some contraindications for being choked: heart conditions, hypertension, young kids. But people who are choked out for ten or thirty seconds seem to be fine within five minutes, and certainly by the next day. Being choked out repeatedly would seem to be a bad idea.

I'm not going to go out and try to get choked out. But if it happens in the course of training or competing, the only thing I'm worried about is that someone notices before too much time passes. Students should know to pay attention to their partner and not hold onto a choke with a limp partner. Instructors should pay attention to students who are grappling, taking particular note of those caught in a choke, and make sure nobody holds on to a choke after the other person passes out. These simple precautions have, according to the data, largely prevented choke-related serious injury in one of the world's most practiced martial arts.

Normal practice of grappling chokes is almost entirely safe. One instance of being choked out and immediately resuscitated doesn't appear to have any serious negative consequences, say both anecdotes and the data.

So barring contraindications, choke away, judoka.

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re: "The electroencephalograph recorded symptoms very similar to that of a short epileptic seizure." nytimes.com/2003/02/18/health/… One occurrence here and there is unlikely to hurt anyone, but recurrent exposure can create worse conditions, too. Basic "rule of thumb": Everything in moderation. –  stslavik May 3 '12 at 18:07
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@stslavik If the similarities between choking and epilepsy hold true, which the electroencephalogram only hints at, then repeated chokings-to-unconsciousness might cause damage (such as shrinking of the hippocampus), which would give us a marginal increase in health risks. Since we're talking about maybe half a dozen choke-outs over a lifetime maximum, as compared to uncontrolled epileptics, my Bat-signal is not going off. –  Dave Liepmann May 3 '12 at 18:33
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The common groundhog hides its head every time it sees a shadow, regardless of whether it's a predator or not. It develops this as a self-preservation instinct; those that do not duck when the wrong shadow crosses over are eaten. Just something to consider. –  stslavik May 3 '12 at 21:27
    
"The LVNR system has specific after care guidelines. Officers must obtain field medical clearance for subjects who were placed in the LVNR whether they were rendered unconscious or not. There is a mandatory 2 hour observation period for anyone who has had the LVNR applied. [...] not to be applied to people with cardiac disorders, children" -- this very clearly suggests that they are not at all concerned about potential ill effects or lethalities :-) –  Damon Nov 5 '12 at 16:42
    
@Damon Kowai goes into fair detail describing how law enforcement's LVNR should not be considered the same as properly trained and applied martial arts chokes. I would also be interested to see if the after-care guidelines were based in medicine or were just a legal way to cover their behind. –  Dave Liepmann Nov 5 '12 at 17:36

Choking becomes EXPONENTIALLY more dangerous as time goes by. That is, two minutes is FOUR times (or more) dangerous than one minute.

An example of a "timetable can come from hanging, or strangulation, which takes about 30 minutes. A person is "half dead" after about 22 minutes, goes unconscious at about 25, and is brain dead at about minute 27.

Choking is more dangerous than hanging 1) because it is concentrated, that is, a person choked to death will die in 7 minutes, not 30, and

2) Because in a hanging situation, the first few minutes drains the body of excess oxygen, meaning that the "real damage" isn't done until the minutes get into double digits.

In martial arts, choking takes place at the end of a fight that may have already drained oxygen, and choking may start to do damage right away. So if a person passes out, s/he can be MINUTES (5) away from death.

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Do you have any sources for these numbers? I don't necessarily disagree with any of them, I just wonder where you got them. –  Dave Liepmann Apr 27 '12 at 15:44
    
@Dave Liepmann: In finance, I was once told that the mathematics of a 30 minute hanging worked much like a 30 year "mortgage" (a debt to be "killed" (mort is French for death). The amortization payment is set about 10% above the interest, and hanging (unlike choking) allows oxygen intake about 90% of what is necessary for life. The impact is minimal at first, and increases through compounding. A 30-year mortgage is reduced by half after 22 years, and likewise a hanged person is half dead after 22 minutes. A "full" choke takes 7 minutes (as long as one can live with NO oxygen), not 30. –  Tom Au Apr 27 '12 at 18:20
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Just to be clear, you're saying that A) it takes 30 minutes to hang someone to death with a noose, B) it takes 7 minutes to choke someone to death, and C) you learned this in some sort of finance class or job? –  Dave Liepmann Apr 27 '12 at 18:23
    
@DaveLiepmann: The mechanics of hanging and choking, I learned years ago from Encyclopedia Britannica. For a hanging scene, I refer you to "Quiet Flows the Don." For the mathematics, a hanging can take place in 25 minutes or 35 or whatever, just as a mortgage can be set for 25 years or 35. But the "standard" hanging (given a certain tightness of the rope and gravitational forces) required about 30 minutes, just as a "standard" mortgage is 30 years given certain relationships between the repayment and interest rates. –  Tom Au Apr 27 '12 at 18:34
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A hanging actually causes instant death. It is not designed to suffocate. The downward drop with the head being secured with a noose actually causes separation of the head and the neck, effectively decapitating the victim. Just to be clear. –  Ben Richards Jul 1 '12 at 6:51

As a former LAPD police man who went through academy training in the early 70s, I can give testimony about the bar arm control hold and its effects, on other police cadets and myself as well. We were taught to know what to do when gaining consciousness, how to identify by hearing, where our main threat was (man with a gun) and how to proceed. Naturally in order to do that, we were choked out no less than 20 times during training. We were trained to use the bar arm control hold, which consisted in turning the adversary around from a frontal position, by keeping our gun leg back, extending our left hand inches beyond his right arm and hitting and pushing his right shoulder hard. Well applied, this maneuver resulted in turning the person around, into the cutting side of our right forearm, while our left hand was locked on to our right one, applying force to the subject's neck pressing him aginst our chest. Ounce that maneuver was done, his arched body was taken down hard to the ground by retrieving our left leg.If the choke hold was well applied, he was supposed to be out by the time he hit the floor. When the choke hold was applied to me by training officers, supposedly experts in martial art, it was not painful at all. It was swift and quick, because the martial arts expert, maintained at all times the pressure on the neck and of course there was no resistance from the me, since this was just a demonstration. The problem started when the choke hold was applied by trainee to trainee in an effort to get it right. In my class, at least two persons were taken out of the field by ambulance, and one was never seen again. In my case, weeks after wrestling classmates ussually 40 to 60 pounds heavier than me, and being choked out almost daily, or even choking out some classmate, I started to have migraines, vertigo, pain and stiffness of neck and other symptoms. I reported all these to my superiors at the academy, but complaining about pain was not part of the job description, so I went on to graduate and stayed on the job for about 7 years. Eventually I was given a stress IOD type pension. An evaluation by a Neurologist was performed a couple of years ago, and subsequent testing (brain and cervical MRIs and xrays) revealed significant and important lesions from c3 to c7. These lesions are congruent with a great amount of pressure applied to my neck. They are degenarative, and may be the cause of headaches, sleep paralysis, and a whole series of symptoms, that are often confused with stress and other psychological ailments.

To conclude this commentary, let me just emphasize that choke holds applied by martial arts experts may result and minimal to no permanent lesions, but the barm arm control hold, or the caratoid version, use in law enforcement by officers, even when it is well intended to just control and avoid lethal force, is not being applied by experts, nor to persons that may tap out, which may lead to: death...permanent neurological injury to brain and back to the suspect, it may also be the cause of lesions to back and knees of the officer, because if it happens in the field, the patient is taken down hard to the ground and the officer absorbs the impact falling hard on his knees, not on a training padded surface or grass, but ussually on a concrete paved street. I respectully advised retired or active officers to consider my experience and seek profesional neurological evaluation when faced with headaches, tingling sensation of back of head, hands and feet, pain on back of legs, unsteady gait, urinary incontinence of any type, pain in lower back that extends to gluteus, even lose of sexual drive. In my humble opinion any officer who went through the barm arm experience and lost of consciousness at the academy, should have a neurological evaluation and testing.

The same advice goes to any person, whom might have been choked out, lost consciousness and is know exprience some of this symptoms.

Thanks for your patience and tolerance

E.R. Jimenez

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The distinction between "blood choke" and "air choke" does not make sense from a medical point of view, especially when unconsciousness is involved.

Any form of unconsciousness is perilous (in a sense of "possibly lethal"). You are entirely right about feeling scared, unconsciousness is scary. The body loses its adverse-effects reflexes, which can easily result in death by aspiration/asphyxia even on an entirely healthy person. Also, secondary effects (e.g. circulatory or neurological ones) which you may or may not notice and which you may or may not be able to handle can join in at any time.
Certainly, not everybody who goes unconscious for a moment dies, but it's something you cannot safely assert at that moment.

Hyperextension of the neck as learned as one of the basic measures in every first aid course is helpful in such a situation, it literally saves lives. It's the first thing you want to do when someone doesn't come back within a few seconds.
Since you said you wouldn't have known what to do, this is a valuable thing to look into.

As for which is more dangerous, "blood" or "air" choke, both are -- also in absence of unconsciousness -- equally dangerous insofar as both can easily cause severe side effects and death.

It doesn't take much to break the thyroid cartilage, and if that happens, you're in trouble (or rather, for the time being the other person is, you'll be in trouble when the police arrives).

It also doesn't take much on some people to stimulate the vagus nerve so they develop a sudden bradycardia with extreme hypotension. This is very individual, and you only know when it's too late. Extreme hypotension can, even when people tell you "of course I'm alright" a few minutes later, result in organ failure (usually the kidney) up to 48 hours later.
Also, a "blood choke" results not only in oxygen depletion, but also in a sudden change of blood pressure in the brain. Most martial artists should hopefully be healthy people, but you never know -- there are young and apparently healthy people with aneurysms, too. When you find out, it's too late.

Thus, all in all, choke with care, be responsible and stop early before someone goes unconscious.

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Do you have any reports of any of these things happening in the course of martial arts training? –  Dave Liepmann Nov 4 '12 at 4:41
    
@DaveLiepmann: Carotis sinus massage is a known therapy for supraventricular tachycardia, and a known cause of vagovasal syncope. I recall seeing the latter once with school kids choking each other. Shock kidney is something I've seen 4 or 5 times in my life in people who were "fine" after trauma with shock. Death due to aneurism in young people is admittely something that I do NOT remember seeing ever, but it is something that can conceivably happen given a) enough "stimulation" and b) being unlucky to have an aneurism. –  Damon Nov 4 '12 at 12:51
    
Can you tell us what caused the shock kidney trauma? I assume it wasn't martial arts training. And correct me if I'm wrong, but isn't vasovagal syncope via carotid sinus massage the goal of training chokes, and a large part of the subject of the question itself? –  Dave Liepmann Nov 4 '12 at 17:44
    
@DaveLiepmann: The reason of shock kidney is an extreme hypotonia, whatever the reason (that's secondary). I can't tell about vasovagal syncopes being a "training goal", but in my opinion this would be a rather stupid goal, as it is dangerous. You could as well have your partner stab you in the eyes or repeatedly kick you in the testicles (without protection ofc) to "harden" them. Some things are just dangerous, and one shouldn't do them, simply because they're dangerous. Doing dangerous things for "training" leads to Bad Things Happening™. Maybe not the first time, but eventually. –  Damon Nov 4 '12 at 18:48
    
I feel like we're in danger of some circular reasoning. If I understand correctly, the point of training chokes is to force the partner to tap out before they experience a vasovagal syncope. We're trying to determine how dangerous it is if our partner passes out before tapping. As my answer details, all studies of this kind of training seem to show that there is minimal or no risk involved, as long as basic precautions are taken. Saying "choking them unconscious is dangerous because they're unconscious" doesn't really shed light on the situation. Or did I not catch part of your position? –  Dave Liepmann Nov 4 '12 at 20:53

On a healthy adult with no pre-existing conditions that could be exacerbated by the choke, it's not dangerous at all. The problem with that is you might only find out there was a condition after the fact.

Choking out your instructor - no big deal, he probably didn't get to where he is with a heart condition, and with his experience the onus to tap is really on him.

Choking out a white belt should be avoided at all costs. If there's a referee who's keeping an eye on things you can off course wait for the ref to stop it or for the tap (when I'm reffing I ask the athletes to keep their eyes open, the moment I see them lose focus, or if their eyes are obscured while in a choke I stop the match). If there's no ref present, you have to moderate yourself. If the tap doesn't come within a few seconds of sinking in the choke, let go. Either the other guy is stubborn and doesn't want to tap (don't let that become your problem by choking him out and finding he's one of the few cases where something bad happens!), or your choke wasn't very good. Either way, let go, move on to something else.

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I recently found an article by Wendy Gunther Sensei, which asserts that during a controlled study there was no long term damage from chokes. Short term interruptions in blood flow, transient EEG anomalies but in each case the recipient of the choke returned to full functionality quickly. The referenced article does mention some more serious consequences that could occur, but should not if training under a competent instructor in a controlled environment. This contradicts what I've been told by others, and I think the subject merits further research.

Update: @Dave Liepman asked me to check with the MD's in my dojo who assert that there are dangers to chokes. I'm still checking the facts, but Sempai said that one of our students who was a neurosurgeon found "pukka's" (phonetic spelling) on the brain of people who had suffered chokeholds, and that furthermore one of our top judo players (a national competitor who has more chokeouts than the rest of us put together) had an unusually large number of pukka's on his brain. I need to check how strong the correllation is - I know who the MD in question is, but he no longer practices with us. I'll see if I can get contact information and follow through.

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What is contradicted? What about it merits further research? And shouldn't Wendy's analysis be taken with a grain of salt after she says something as frankly ignorant as "I would never practice chokes with a face-down opponent", after admitting she has essentially no experience with judo, an art in which choking people face-down happens hundreds of times worldwide literally every day? –  Dave Liepmann Nov 4 '12 at 1:33
    
This "ignorant" statement shows that she has an understanding of human physiology (not very surprising considering her profession) and at least a minimum of responsibility. The fact that something happens hundreds of times every day has absolutely no bearing. In Pamplona, thousands participate in bull running every year. During the last 80 years, only 15 people have died due to injuries. According to your reasoning, one could argue that running down a narrow street followed by two dozen angry and panicking bulls is perfectly safe, reasonable, and advisable. –  Damon Nov 5 '12 at 18:28
    
@Damon That's a caricature of my reasoning. 15 people dying is at least a fairly serious chance of injury compared to 0 people dying from training chokes with the basic precautions noted in my answer, as Kowai and various judo organizations have noted. The data shows that our time would be better spent warning people about poorly applied uchimata attacks that endanger the neck. Let me put it this way: is there any data that could conceivably convince you that chokes are safe? –  Dave Liepmann Nov 5 '12 at 19:42
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Her statement is equivalent to saying "I would never practice a header in soccer, because although I've never played the sport, it looks like it would cause cerebral hemorrhages." It's quite clearly a statement that is ignorant of the plain fact that millions of people do practice these things with no evidence of ill effect either chronic or acute. Judo is one of the top practiced sports in the world. Wouldn't you think we'd have had at least one case of someone falling down dead from a choke by now, if it were going to happen? –  Dave Liepmann Nov 5 '12 at 19:46
    
@DaveLiepmann asks to what contradiction I refer. In an earlier post, I'd mentioned that MD's in my dojo claim to have seen evidence of brain damage resulting from chokeholds. I freely admit I'm not an MD and I don't pretend to have the knowledge to interpret or explain a brain scan. The article I cite in this answer contradicts the evidence I offered earlier. To my mind, that contradiction means that I should do further research. I did not intend to create this level of heat/fractious argument. I was just trying to be responsible about my earlier claim. –  Mark C. Wallace Nov 5 '12 at 21:21

I think chokes are some of the safest submissions in BJJ/Submission grappling and thus it's okay to train them as often as you want. I think the main factor in terms of danger is making sure you're training with someone you trust. Anything in martial arts can potentially be dangerous if your training partner has the wrong mindset.

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protected by David H. Clements Dec 30 '12 at 4:50

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