Chokeholds: Could MMA Fighting Techniques Be Used in Crimes? January 10, 2023
PCOM Forensic Pathologist Raises Awareness for Possible Links
With the continued popularity of mixed martial arts, driven by televised competitions
like Ultimate Fighting Championship, a Philadelphia College of Osteopathic Medicine (PCOM) expert in forensic pathology is raising awareness that chokeholds could become a
more common form of injury or homicide and is encouraging police investigators and
medical examiners to be more alert of signs of strangulation originating from fighting
His perspective is not only informed by his profession. Gregory McDonald, DO, dean of the School of Health Sciences and chair of the Department of Forensic Medicine and Pathology, has trained in various martial arts—including karate, judo and Brazilian jiu-jitsu—and
will soon take his second-degree black belt test in the Israeli martial art Krav Maga.
“With more and more people training in mixed martial arts as a form of exercise and
self-defense, forensic pathologists are likely going to see more deaths by chokeholds
in a variety of cases, such as street fights or domestic violence incidents,” McDonald
said. “These scenarios may also include a change in the common assumption that victims
of chokeholds are smaller and weaker than their perpetrator. Because chokeholds can
be quick and efficient, you can have a smaller person potentially killing a larger
McDonald recently presented a research seminar, titled “The Pathology of Chokeholds
in Mixed Martial Arts,” to help inform the medical community about ways to identify
effects from chokeholds (which, McDonald clarified, are actually vascular neck restraints,
a form of strangulation to restrict blood flow to the brain and induce unconsciousness).
Chokeholds work primarily by compressing one or both of the carotid arteries in the
neck. This only takes about 10 pounds of pressure—the equivalent of a firm handshake,
McDonald said—and can cause unconsciousness in about 10 seconds. In two minutes, permanent
neurologic damage can occur. At three to four minutes, death can result. The jugular
veins can be compressed with even less pressure—just four to five pounds. This pressure
can cause veins to rupture, leading to pinpoint hemorrhages known as petechiae, or
discolored spots on the skin due to blood clotting, which can be telltale signs of
Chokeholds can be applied manually, using the hands, forearms, or legs, or with a
ligature, such as a rope, belt, or clothing. Chokehold attacks can come from any direction,
and there are myriad types. At his recent seminar, McDonald described a few: the air
choke (pressure on the larynx and trachea instead of the carotids), the arm or leg
triangle, and the collar or sleeve choke.
Signs of Strangulation
Strangulation symptoms are as varied as chokehold types, some of which leave subtle
signs due to how they’re applied. McDonald encourages investigators to examine the
victim’s clothing and, if possible, the alleged perpetrator’s, for potential evidence
such as tears, stretches, missing buttons or damaged zippers. Or, if the clothing
is loose, it could be more easily manipulated to strangle or throw a victim.
In addition to trace evidence that could indicate a struggle (dirt, gravel, grass
stains on the body or clothing), strangulation symptoms include dissections of the
carotid or vertebral arteries. There are also various neurologic symptoms: visual
field loss, fine motor deficits, or coma, and these symptoms may occur hours or even
days after strangulation. Delayed-onset symptoms and results—a stroke caused by a
choke may contribute to a delayed homicide, for example—may make the link to a chokehold
even more of a challenge.
McDonald added that physical findings could be even less visible on larger victims,
especially if the duration of the assault is short. Chokeholds “may leave a paucity
of injuries,” he said, increasing the importance of awareness among authorities about
MMA techniques, how they can be applied, and what could happen as a result.
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