What’s safer? Being knocked unconscious or being strangled to a point of unconsciousness? In a sport setting the answer seems to be the latter with strangulation submission techniques not (from research to date) appearing to be linked to the brain disease CTE.
A recent literature review was recently published briefly discussing this. The paper, titled Chokes In Grappling and Mixed Martial Arts: Types, Mechanisms Of Action, Consequences And Management. A Systemic Review was published earlier this year in the Nortis Journal of Sports Sciences and is available on line for free.
As the title suggests the authors reviewed peer reviewed literature addressing the safety and risks of sport strangulations. While they carry some risk the techniques appear to be generally safe in a structured setting. In touching on the lack of known connection from sportive strangulation and CTE the authors note as follows
“To date, scientific literature has not established a relationship between repeated transient strangulations and the development of chronic traumatic encephalopathy (CTE). Unlike impact trauma (strikes), brief hypoxic mechanisms do not appear to generate the same degenerative damage.“
The full abstract reads as follows:
The aim of this study is to provide an overview of the fundamental aspects of chokes in grappling sports and mixed martial art. Chokes constitute a fundamental component in certain hand-to-hand combat systems. From a medical standpoint, most correspond to vascular strangulations, whose primary mechanism is external compression of the carotid arteries, resulting in transient reduction of cerebral perfusion pressure and loss of consciousness generally within a few seconds. Unlike striking sports, in which injury occurs through direct mechanical trauma with a well-established association with concussion and chronic traumatic encephalopathy (CTE), strangulations act through reversible hemodynamic alteration and, to date, have not demonstrated a consistent link with CTE. Studies in high-performance grapplers demonstrate neurophysiological adaptations, including increased baseline cerebral blood flow and preserved cognition, suggesting a possible phenomenon of ischemic preconditioning. However, although generally safe in supervised sporting environments, strangulations are not without risk. Cervical artery dissections, ischemic strokes, and structural laryngeal injuries have been documented, particularly in improperly applied or prolonged maneuvers. Early recognition of warning symptoms -focal neurological deficits, severe headache, dysphonia, dysphagia, or dyspnea- is crucial, and neck CT angiography is the diagnostic study of choice when vascular or structural injury is suspected. Understanding the physiology, risks, and differences compared with impact related trauma is essential to optimize safety, clinical practice, and decision-making in grappling sports.
Combat Sports Law 