BRIEF REVIEW: TIME TO LOSS OF CONSCIOUSNESS FOLLOWING A STROKE

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Combative choking techniques (more accurately described as strangulations) are commonly used techniques in a wide range of combat sports and arts, as well as in law enforcement. The goal of a strangulation is to cause bilateral compression of the carotid artery and jugular vein, decreasing the cerebral perfusion pressure and leading to a loss of consciousness (LOC). An understanding of the likely time to LOC is important both for athletes looking to maximise the effectiveness and safety of their technique, as well as for law enforcement officers looking to minimise potential harm. Previous research in compliant (not defending/resisting the technique) subjects has shown a range of 5 to 19 seconds, with most studies determining 7-11 seconds as an average time to LOC. However, to date there have been no studies examining time to LOC in actual sportive combat.

A 17-member panel of submission experts (including BJJ black belts, experienced grapplers, former MMA athletes, and medical professionals) analysed 81 UFC matches between 1993 and 2020 that ended in strangulation submission due to a LOC (as opposed to tapping). Each examiner reviewed each film (blinded to the other’s interpretation) to determine the time between full application of the technique and LOC.

The mean time to LOC was 9.0 seconds, with a standard deviation of 2.5s. There was no difference between neck-only and arm-in choke times, and only the arm triangle displayed a significantly faster time to LOC of 7.2 seconds.

These results were consistent with previous studies in compliant volunteers, indicating that skillfull application of a choking/strangulation technique will cause LOC regardless of defense mechanism. 

  1. Stellpflug SJ, Menton WH, Dummer MF, Menton T, Corry J, LeFevere R. Time to unconsciousness from sportive chokes in fully resisting highly trained combatants. Int J Perform Anal Sport. 2020;20(4):720–728.

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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