I'm curious what you guys think about this situation? Link and story text further down. Let me say first that I am sympathetic to this person's passing and to his family. When I first started grappling, I was concerned about chokes. I looked for what publications I could find regarding BJJ chokes and safety concerns, some were written by physicians that also practiced BJJ and some did not. The general concensus seemed to be that under normal training circumstances, there was very little chance of any real damage from a properly applied choke. The biggest risk mentioned was dislodging plaque in the arteries potentially leading to a stroke, but was a small risk that is primarily a concern for older practitioners. Anyway, this story tries to link the death of a BJJ fighter two days after he was choked out in class to that RNC technique, and a lack of concern from the healthcare professionals that saw him. What do you guys think? Could the RNC have been the cause of his issue and ultimately his death? http://www.bjpenn.com/rip-bjj-fighter-dies-after-rear-naked-choke/ "RIP! BJJ Fighter Dies After Rear-Naked-Choke October 7, 2015 2:12 pm MMA News Jiu-Jitsu isn’t a sport where you see a lot of deadly injuries. Unlike fighting, boxing and other high impact sports, BJJ doesn’t involve strikes or big throws. However, major injuries do happen and unfortunately Globo is reporting that a 32-year-old jujitsu student in Brazil has died, several days after being choked with a RNC during class. A 32-year jujitsu student died in Brasilia due to a hold known as “rear naked choke” during a class on 21 September in Ceilândia. The family says that Napoleon José Alves was taken to a public hospital for two days straight and did not receive care because the case was not considered serious. A few days later he was treated, but was found brain dead. The family of the man said he was feeling bad and they took him to the hospital following being choked in class. He allegedly did not receive proper treatment and was told that his situation wasn’t serious. Days later, he died."
It's not just plaque being dislodged that can lead to arterial embolism, but also clots from injury to the artery wall. I think it's impossible to say how much effect the RNC had on this guy's risk of death, because we have no knowledge of any extant pathology.
Do they specify how he died? Maybe one of those one in a million arteries that folded in on itself. Anyway, the medical staff seriously failed here if he was back twice in two days.
A properly applied RNC? No That said if it was in an active roll, or the technique was off it COULD have caused throat trauma had pressure been applied to the trachea instead of the carotids. Given the time lapse involved however I would be surprised if the choke itself was the cause and would look to other medical factors. It is reminiscent of the Garner case where the choke was blamed for his death when in actuality the direct causes were from elsewhere
They didn't delve into the specifics in the article, and it doesn't seem like the staff at the hospital ever really tried to diagnose the issue. Hopefully they do autopsies there.
This is an extract from - rather fittingly - a review done by Calgary Police. The potential effects from a correctly applied choke are: The same review also includes the extensive reviews conducted of further evidence dating form the 60's I am sure there are more up to date studies too, but in all cases - including in custody deaths - the effects of an applied choke/strangle/LVNR have an INSTANT to short term manifestation; there is no recorded "2 day delay" simply due to the nature of the injury potential.
"Correctly" being the operative word. Damage to the airway can lead to delayed fatal airway collapse. "When the laryngeal cartilaginous framework is intact, soft tissue oedema and haematoma of the supraglottis are the most frequent causes of upper airway distress. Swelling may develop quickly or insidiously, leading to upper airway occlusion several hours after assault. Visible neck signs are rarely present immediately after aggression. These features explain why victims of strangulation are often clinically underestimated. Due to the fact that damage caused by manual strangulation can be fatal even when there are few or no signs of assault, medical evaluation should be thorough and timely. Assessment of internal injury is not a lengthy procedure and can save lives. For as long as 36 hours after assault, the victim can develop oedema of the supraglottal and oropharyngeal soft tissue, causing airway obstruction. Variables include the mode and force of com- pression as well as patient age and general medical condition. Though it is difficult to recognise which patients could be susceptible haematoma formation, vigilance is necessary in all cases." - http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.389.8597&rep=rep1&type=pdf [WARNING: CONTAINS PHOTOGRAPHS OF AUTOPSY].
Even in incorrectly applied ones the injury is relatively rapid in its manifestation, again due to the area being traumatized
Wasn't it basically tradition that pretty much every Judoka was deliberately choked out at some point? Usually by a senoir? Just to show the effects or as some sort of initiation? I remember Neil Adams saying he got choked out by Brian Jacks in that way (and was not a fan of it). As such I would expect any risk to be quite apparent years ago?
Well, the literature is saying up to 36 hours after manual strangulation, and often with little exterior sign of damage. Sore throat and some speech difficulties, but no more than a bad throat infection would cause. Still, this is straying off-piste, as I'm presuming that kind of strangulation is not likely to have occurred in a BJJ gym.
Just for information sake, some person's have either plaques or susceptibility to damage of the wall of the artery(micro-trauma) where either can set up a progressive injury that can take up to 2 weeks to appear after the initial incident. The confounding factor is that these individuals often have a history of some sort of cardio-vascular condition that will make them susceptible to injury and this needs to be watched for (pre-training medical screen?). There was a research study done that showed that in persons under 45, the number one thing correlated with injury, for person's who have had a stroke (unusual event), was having their neck manipulated in the prior 2 weeks. This is a concern as it is difficult to predict when this will occur, if the event would have been spontaneously occurred otherwise(under 45 it's unusual) and if anything could have been done to prevent the complication from happening. Now Ii am not saying that this is a common thing (it is not) but it is a risk that people working on necks need to be aware of. Perhaps this is also the sort of thing that was involved in causing this BJJ students death?
Good to know, although at the risk of getting semantic I would again suggest the choke is not the cause per se - merely the catalyst
International Framework for Examination of the Cervical Region for potential of Cervical Arterial Dysfunction prior to Orthopaedic Manual Therapy Intervention Authors: Rushton A, Rivett D, Carlesso L, Flynn T, Hing W, Kerry R. Cervical arterial dysfunction The following risk factors are associated with an increased risk of either internal carotid or vertebrobasilar arterial pathology and should be thoroughly assessed during the patient history (Arnold and Bousser, 2005; Kerry et al, 2008): Past history of trauma to cervical spine / cervical vessels History of migraine-type headache Hypertension Hypercholesterolemia / hyperlipidemia Cardiac disease, vascular disease, previous cerebrovascular accident or transient ischaemic attack Diabetes mellitus Blood clotting disorders / alterations in blood properties (e.g. hyperhomocysteinemia) Anticoagulant therapy Long-term use of steroids History of smoking Recent infection Immediately post partum Trivial head or neck trauma (Haneline and Lewkovich, 2005; Thomas et al, 2011) Absence of a plausible mechanical explanation for the patient’s symptoms.
Well the question is, at least one that I would ask, do you think that people wrestling/grappling are in a position where they might, either in one session or over time, cause trauma to their necks? I had my front teeth broken getting caught in a throw in school. I know that people often struggle when doing newazza and might cause themselves some neck injury even if tori was not being overly rough. But to a degree you are corrrect, the trauma is setting off something hidden. Thus you might want to ask your students their history before you put them i a position where something could go wrong. I think the term used in the UK is risk assessment. Just sayin' :' D LFD
Correlation doesn't equal causation, I'd have to know a lot more of the specifics before I even had an opinion. PS generally that's why you tap early, if your passing out instead of tapping regularly, your too dumb to train regularly.
Something like this ... ( although this guy was expecting just a demo but due to a 'lost in translation' type misunderstanding got the full experience ) [ame="https://www.youtube.com/watch?v=fHAEt7G0S9M"]Female MMA Fighter Cris Cyborg Chokes out Reporter - YouTube[/ame]
