On January 2, 2023, American football Buffalo Bills safety Damar Hamlin, in a Monday Night Football game against the Cincinnati Bengals, collapsed on the field at 8:56 p.m EST after tackling wide receiver Tee Higgins and required immediate emergency medical treatment, apparently for commotio cordis (Latin for “agitation of the heart,” where ane impulse from a colliding object disrupts the normal heart rhythm and leads to sudden cardiac arrest).

I could not see the tackle clearly on the video I watched, but I thought I saw Higgins with an arm straight out with hand in palm heel strike form hit Hamlin as he tacked him (otherwise known in football as a "stiff arm"). Descriptions in media say it was Higgins using his right shoulder (I note that I was taught in kyokushin to use the shoulder to strike also, useful when your hands are bound).

Can anyone confirm my suspicion that this was a palm heel strike to the heart?


2 Answers 2


No. If you watch the footage, Higgins hits with his shoulder to Hamlin's chest.

Image of Higgins right before impact A still from the other side

That makes sense because one of the most important things about carrying the ball is not dropping it before you're down, or have made a touchdown, so you cradle it unless you don't have a choice, especially right before an imminent collision.

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    In the left image I seem to see only Higgins right shoulder lowered, not a stiff arm strike. The right image though is comfusing since it shows Higgins parallel more or less, but that seems to be post-impact, judging by Hamlin's posture (headed back from the impact). It was worth making the post only to get folks talking about strikes to the chest that can cause the heart to stop (relies on coincident timing of target heart beat unless multiple high speed punches delivered, absent gross cardiac defect prior).. Jan 10, 2023 at 16:07
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    As far as I can tell, there was no fight between Hamlin and Higgins. What happened was just a horrible, horrible freak accident. Feb 2, 2023 at 5:27

There seems to be an underlying misconception:

Hearts don't reliably stop due to some physical impetus from outside the thorax at that age.

While this can an does happen at a younger age and has to happen at exactly the right speed, in the right angle, at a very specific time in the cardiac cycle (cheers to JohnP for a proper source), it is pretty unlikely in that age without underlying conditions.

Therefore, it does not matter much whether the impact was due to a palm strike or a shoulder check (it was the latter). That condition was not primarily due to the impact, it was due to another, underlying cardiac condition like an extreme case of cardiac muscle hypertrophy or other ischaemic conditions affecting the innervation and/or the muscle.

Long story short: nothing martial arts here, really. While it can happen in younger athletes during testosterone-rich growth given very specific timing and impact-characteristics, this was probably due to conditions that are not normal in his age and can certainly not reliably be exploited.

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    Funnily enough, the unusual thing about this is that usually this is a baseball or softball injury resulting from someone getting hit with the pitch. Still a rare accident there too. Jan 10, 2023 at 11:25
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    Commotio Cordis happens to a handful of athletes every year and doesn't necessarily need an underlying condition. A blow to the chest at a certain point in the repolarization cycle has been shown to cause this. Mostly a mid teens to early 20's thing, and usually caused by a ball. A nice writeup is here, but it does not have to have an underlying condition - ahajournals.org/doi/full/10.1161/circep.111.962712
    – JohnP
    Jan 10, 2023 at 14:04
  • @JohnP As your own source points out, this is highly unlikely in that age, yes. Both the ribs themselves and the costo-sternal cartilage are more stable and there is no "race" between the organs and the thorax growing anymore. I also highly suspect that testosterone levels have something to do with (relative) cardiac hypertrophy in that age range. Thus, it is highly unlikely that this happened without an underlying condition like exercise-induced cardiomegaly. But you are correct, I should add the caveat of him not being in an age where this happens without that. Jan 10, 2023 at 17:39
  • I think you misunderstood-.There is absolutely no requirement for any kind of underlying condition for CC to happen. None. It's easier if there is, but it's not a necessity. Similar to how a precordial thump works, it's just anatomy. It's been reported in people as old as 45 and as young as 3 months.
    – JohnP
    Jan 11, 2023 at 14:33
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    @JohnP Yep. 37 foot-pounds of force applied at the right time (impact occurring within a specific 10- to 30-ms portion of the cardiac cycle...ascending phase of the T wave when the left ventricle is repolarizing, moving from systole to diastole) on the precordium may cause cardiac arrest, less force required if heart under ischemic conditions en.wikipedia.org/wiki/Commotio_cordis. For comparison, Mike Tyson was rated at 1200 foot-pounds punch. I should admit I am a head-hunter though, kill the head and the body dies as it were (more reliable). Jan 11, 2023 at 15:08

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