# Strangling

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Compression of the neck that may lead to unconsciousness or death

"Strangle" redirects here. For options strategy in finance, see [Strangle (options)](/source/Strangle_(options)).

"Strangulation" redirects here. For bowel strangulation, see [Strangulation (bowel)](/source/Strangulation_(bowel)). For domestic violence strangulation, see [Strangulation in domestic violence](/source/Strangulation_in_domestic_violence).

Look up ***[strangling](https://en.wiktionary.org/wiki/Special:Search/strangling)*** in Wiktionary, the free dictionary.

A [cheetah](/source/Cheetah) strangling an [impala](/source/Impala), [Timbavati Game Reserve](/source/Timbavati_Game_Reserve), South Africa

**Strangling** or **strangulation** is the compression of the [neck](/source/Neck) leading to an increasingly [hypoxic](/source/Hypoxia_(medical)) state in the brain, which can lead to [unconsciousness](/source/Unconsciousness) or even [death](/source/Death).[1] Fatal strangulation typically occurs in cases of violence, accidents, and is one of two main ways that [hanging](/source/Hanging) causes death (alongside breaking the victim's neck).

Strangling does not have to be fatal; limited or interrupted strangling is practiced in [erotic asphyxia](/source/Erotic_asphyxiation), in the [choking game](/source/Choking_game), and is an important technique in many [combat sports](/source/Combat_sport) and [self-defense](/source/Self-defense) systems. Strangling can be divided into three general types according to the mechanism used:[2][*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

- Hanging — Suspension from a cord wound around the neck

- Ligature strangulation — Strangulation without suspension using some form of cord-like object ([ligature](/source/Ligature_(medicine))) called a [garrote](/source/Garrote)

- Manual strangulation — Strangulation using the fingers, hands, or other extremity

## General

The neck contains several vulnerable targets for compression including the [carotid arteries](/source/Carotid_arteries).

Strangling involves one or several mechanisms that interfere with the normal flow of [oxygen](/source/Oxygen) into the brain:[3][4]

- Compression of the [carotid arteries](/source/Carotid_arteries) or [jugular veins](/source/Jugular_veins)—causing [cerebral ischemia](/source/Cerebral_ischemia).

- Compression of the [laryngopharynx](/source/Laryngopharynx), [larynx](/source/Larynx), or [trachea](/source/Vertebrate_trachea)—causing [asphyxia](/source/Asphyxia).

- Stimulation of the [carotid sinus reflex](/source/Carotid_sinus_reflex)—causing [bradycardia](/source/Bradycardia), [hypotension](/source/Hypotension), or both.

Depending on the particular method of strangulation, one or several of these typically occur in combination; [vascular obstruction](/source/Cerebral_ischemia) is usually the main mechanism.[5] Complete obstruction of blood flow to the brain is associated with irreversible [neurological damage](/source/Brain_damage) and [death](/source/Death),[6] but during strangulation there is still unimpeded blood flow in the [vertebral arteries](/source/Vertebral_arteries).[7] Estimates have been made that significant occlusion of the [carotid arteries](/source/Carotid_arteries) and [jugular veins](/source/Jugular_veins) occurs with a pressure of around 3.4 N/cm2 (4.9 psi), while the [trachea](/source/Vertebrate_trachea) demands six times more at approximately 22 N/cm2 (32 psi).[8]

As in all cases of strangulation, the rapidity of death can be affected by the susceptibility to [carotid sinus stimulation](/source/Carotid_sinus_stimulation).[5] [Carotid sinus reflex death](/source/Carotid_sinus#Carotid_sinus_reflex_death) is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed.[3][9] The reported time from application to [unconsciousness](/source/Unconsciousness) varies from 7-14 seconds if effectively applied [10] to one minute in other cases, with death occurring minutes after unconsciousness.[3]

## Manual strangulation

Manual strangulation (also known as "throttling") is strangling with the hands, fingers, or other extremities and sometimes also with blunt objects, such as [batons](/source/Club_(weapon)). Depending on how the strangling is performed, it may compress the [airway](/source/Airway), interfere with the flow of blood in the neck, or work as a combination of the two. Consequently, manual strangulation may damage the larynx[3] and fracture the [hyoid](/source/Hyoid) or other bones in the neck.[5] In cases of airway compression, manual strangling leads to the frightening sensation of [air hunger](/source/Air_hunger) and may induce violent struggling.[3]

Manual strangulation is [common in situations of domestic violence](/source/Strangulation_in_domestic_violence),[11] and is regarded by experts as an especially severe form of [domestic violence](/source/Domestic_violence), due to its extremely frightening and potentially lethal nature, and an observed correlation between non-fatal strangulation in domestic violence and future homicide.[12]

Manual strangulation also has a history as a form of capital punishment. During the 18th century, a sentence of "Death by Throttling" would be passed upon the verdict of a [court martial](/source/Court_martial) for the crime of desertion from the British Army.[13]

More technical variants of manual strangulation are referred to as strangleholds,[14] or [chokeholds](/source/Chokehold) (despite the term "[choke](/source/Choking)" more technically referring to internal airway restriction), and are extensively practised and used in various [martial arts](/source/Martial_arts), [combat sports](/source/Combat_sport), [self-defense](/source/Self-defense) systems, and in military [hand-to-hand combat](/source/Hand-to-hand_combat) application. In some martial arts like [judo](/source/Judo), [Brazilian jiu-jitsu](/source/Brazilian_jiu-jitsu), and [jujutsu](/source/Jujutsu), when applied correctly and released promptly after loss of consciousness, strangleholds that constrict blood flow are regarded as a safer[15] means to render an opponent unconscious, when compared to other methods, especially strikes to the head, the latter of which can cause potentially [catastrophic](/source/Catastrophic_injury) or fatal and irreversible [brain injuries](/source/Traumatic_brain_injury) much more quickly and unpredictably.[16]

## Ligature strangulation

Further information: [Garrote](/source/Garrote)

Illustration depicting the ligature strangulation of [Saint Godelieve](/source/Godelieve)

Ligature strangulation or garroting is strangling with some form of cord such as rope, wire, chain, or shoelaces (a [garrote](/source/Garrote)) either partially or fully circumferencing the neck.[17] Even though the mechanism of strangulation is similar, it is usually distinguished from [hanging](/source/Hanging) by the strangling force being something other than the person's own body weight.[5] Incomplete occlusion of the [carotid arteries](/source/Carotid_arteries) is expected and, in cases of [homicide](/source/Homicide), the victim may struggle for a period of time,[5] with unconsciousness typically occurring in 10 to 15 seconds.[17] Cases of ligature strangulation generally involve homicides of women, children, and the elderly.[5] Compared to hanging, the ligature mark will most likely be located lower on the neck of the victim.

During the [Spanish Inquisition](/source/Spanish_Inquisition), victims who admitted their alleged sins and recanted were killed via ligature strangulation (i.e. the garrote) before their bodies were burnt during the *[auto-da-fé](/source/Auto-da-f%C3%A9)*.[18] Throughout much of the 20th and 21st centuries, the [American Mafia](/source/American_Mafia) used ligature strangulation as a means of murdering their victims. Confessed American [serial killer](/source/Serial_killer) [Altemio Sanchez](/source/Altemio_Sanchez) used ligature strangulation in the rapes and/or murders of his victims, as did [Gary Ridgway](/source/Gary_Ridgway) (the Green River Killer) and the Scottish serial killer [Dennis Nilsen](/source/Dennis_Nilsen).[19]

*Incaprettamento* (derived from a term meaning "to tie up like a [kid goat](/source/Kid_goat)") is a method of strangulation in which the victim's neck is tied to his/her legs bent behind his/her back (similar to a [hogtie](/source/Hogtie)), so that the victim must bend his/her legs in order to loosen the rope and breathe; inevitably, the victim would become exhausted and die of [strangulation](/source/Strangulation). This method was common throughout [Neolithic Europe](/source/Neolithic_Europe), and occurred for over two thousands years in northern and southern Europe, as evidenced by skeletal remains. It is uncertain why it was so common, but researchers speculate a person bound in this way might be considered to have killed themselves, versus being killed by another, perhaps connected to a taboo against killing people of high status. Victims may have been part of a ritual sacrifice. Rock art in Addaura Cave, [Sicily](/source/Sicily), made between 16,000 and 13,000 [BP](/source/Before_Present), depict two human figures bound in the *incaprettamento* manner. Today, it is a method of murder mostly associated with the [Italian Mafia](/source/Italian_Mafia), who have used it as a ritual warning or reprimand.[20][21][22]

## See also

- [Beheading](/source/Decapitation)

- [Capital punishment](/source/Capital_punishment)

- [Constriction](/source/Constriction)

- [Fainting game](/source/Fainting_game)

- [Hanging](/source/Hanging)

- [Long drop](/source/Hanging#Long_drop)

- [Short drop](/source/Short_drop)

- [Strangulation in domestic violence](/source/Strangulation_in_domestic_violence)

- [Thuggee](/source/Thuggee)

## References

1. **[^](#cite_ref-ernoehazy_1-0)** Ernoehazy, William; Ernoehazy, WS. ["Hanging Injuries and Strangulation"](http://www.emedicine.com/emerg/topic227.htm). *emedicine.com*. Retrieved 3 March 2006.

1. **[^](#cite_ref-strack_2-0)** Strack, Gael; McClane, George. ["How to Improve Investigation and Prosecution of Strangulation Cases"](http://www.polaroid.com/global/printer_friendly.jsp?PRODUCT%3C%3Eprd_id=845524441760370). *polaroid.com*. Retrieved 3 March 2006.{{[cite web](https://en.wikipedia.org/wiki/Template:Cite_web)}}: CS1 maint: deprecated archival service ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_deprecated_archival_service))

1. ^ [***a***](#cite_ref-jones_3-0) [***b***](#cite_ref-jones_3-1) [***c***](#cite_ref-jones_3-2) [***d***](#cite_ref-jones_3-3) [***e***](#cite_ref-jones_3-4) Jones, Richard (26 February 2006). ["Asphyxia"](https://web.archive.org/web/20060226102952/http://www.forensicmed.co.uk/asphyxia.htm). *forensicmed.co.uk*. Archived from [the original](http://www.forensicmed.co.uk/asphyxia.htm) on 26 February 2006.

1. **[^](#cite_ref-4)** Jones, Richard. ["Strangulation"](https://web.archive.org/web/20060430224427/http://www.forensicmed.co.uk/strangulation.htm). *forensicmed.co.uk*. Archived from [the original](http://www.forensicmed.co.uk/strangulation.htm) on 30 April 2006. Retrieved 30 April 2006.

1. ^ [***a***](#cite_ref-ferris_5-0) [***b***](#cite_ref-ferris_5-1) [***c***](#cite_ref-ferris_5-2) [***d***](#cite_ref-ferris_5-3) [***e***](#cite_ref-ferris_5-4) [***f***](#cite_ref-ferris_5-5) J. A. J. Ferris. ["Asphyxia"](https://web.archive.org/web/20090927122254/http://www.pathology.ubc.ca/path425/Others/MedicolegalInvestigationOfDeathAndForensic/AsphixiaDrJAJFerris.doc). *pathology.ubc.ca*. Archived from [the original](http://www.pathology.ubc.ca/path425/Others/MedicolegalInvestigationOfDeathAndForensic/AsphixiaDrJAJFerris.doc) on 27 September 2009.

1. **[^](#cite_ref-koiwai2_6-0)** Koiwai, Karl. [How Safe is Choking in Judo?](http://judoinfo.com/chokes5.htm). *judoinfo.com*. URL last accessed 3 March 2006.

1. **[^](#cite_ref-reay_7-0)** Reay, Donald; Eisele, John. [Death from law enforcement neck holds](http://www.charlydmiller.com/LIB/1982neckholds.html). *charlydmiller.com*. URL last accessed 3 March 2006

1. **[^](#cite_ref-gunther_8-0)** Gunther, Wendy. [On Chokes (Medical)](http://www.aikiweb.com/techniques/gunther1.html), with quotations from Spitz and Fisher's *Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation*. *www.aikiweb.com*. URL last accessed 3 March 2006.

1. **[^](#cite_ref-9)** Passig, K. [Carotid Sinus reflex death - a theory and its history](http://www.datenschlag.org/howto/atem/english/csr.html) [Archived](https://web.archive.org/web/20120504044744/http://datenschlag.org/howto/atem/english/csr.html) 2012-05-04 at the [Wayback Machine](/source/Wayback_Machine). *datenschlag.org*. URL last accessed 28 February 2006.

1. **[^](#cite_ref-koiwai_10-0)** Koiwai, Karl. [Deaths Allegedly Caused by the Use of "Choke Holds" (Shime-Waza)](http://judoinfo.com/chokes6.htm). *judoinfo.com* URL last accessed 3 March 2006.

1. **[^](#cite_ref-Sorenson_11-0)** Sorenson SB, Joshi M, Sivitz E (2014). ["A systematic review of the epidemiology of nonfatal strangulation, a human rights and health concern"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202982). *American Journal of Public Health*. **104** (11): e54–61. [doi](/source/Doi_(identifier)):[10.2105/AJPH.2014.302191](https://doi.org/10.2105%2FAJPH.2014.302191). [PMC](/source/PMC_(identifier)) [4202982](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202982). [PMID](/source/PMID_(identifier)) [25211747](https://pubmed.ncbi.nlm.nih.gov/25211747).

1. **[^](#cite_ref-12)** Glass N, Laughon K, Campbell JC, et al. (2008). ["Non-fatal strangulation is an important risk factor for homicide of women"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573025). *J Emerg Med*. **35** (3): 329–335. [doi](/source/Doi_(identifier)):[10.1016/j.jemermed.2007.02.065](https://doi.org/10.1016%2Fj.jemermed.2007.02.065). [PMC](/source/PMC_(identifier)) [2573025](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573025). [PMID](/source/PMID_(identifier)) [17961956](https://pubmed.ncbi.nlm.nih.gov/17961956).

1. **[^](#cite_ref-13)** *Culloden*. BBC Drama Documentary, 1964.

1. **[^](#cite_ref-Danaher_14-0)** ["John Danaher Explains The Difference Between a Choke & a Strangle"](https://www.bjjee.com/articles/john-danaher-explains-the-difference-between-a-choke-a-strangle/). *Bjj Eastern Europe*. 18 December 2020. Retrieved 27 July 2021.

1. **[^](#cite_ref-15)** Buck, Andrew (3 September 2019). ["Blood Chokes: How Do They Work?"](https://findyourgi.com/blood-chokes/). *Find Your Gi*. Retrieved 27 July 2021.

1. **[^](#cite_ref-16)** Green, Aimee (20 July 2015). ["One-punch killings: They happen more often than you might think"](https://www.oregonlive.com/portland/2015/07/one-punch_killings_they_happen.html). *oregonlive*. Advance Publications. Retrieved 27 July 2021.

1. ^ [***a***](#cite_ref-turvey_17-0) [***b***](#cite_ref-turvey_17-1) Turvey, Brent (1996). [A guide to the physical analysis of ligature patterns in homicide investigations](http://www.corpus-delicti.com/ligature.html) [Archived](https://web.archive.org/web/20120724051447/http://www.corpus-delicti.com/ligature.html) 2012-07-24 at the [Wayback Machine](/source/Wayback_Machine). Knowledge Solutions Library, Electronic Publication. *www.corpus-delicti.com*. URL last accessed 1 March 2006.

1. **[^](#cite_ref-18)** Reston, James Jr. *Dogs of God: Columbus, the Inquisition, and the Defeat of the Moors.* Doubleday, 2005. [ISBN](/source/ISBN_(identifier)) [0-385-50848-4](https://en.wikipedia.org/wiki/Special:BookSources/0-385-50848-4).

1. **[^](#cite_ref-19)** [Masters, Brian](/source/Brian_Masters) (1985). *Killing for Company: The Case of Dennis Nilsen*. New York City: [Random House](/source/Random_House). p. 160. [ISBN](/source/ISBN_(identifier)) [978-0-812-83104-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-812-83104-7).

1. **[^](#cite_ref-20)** Metcalfe, Tom (April 10, 2014). ["Neolithic women in Europe were tied up and buried alive in ritual sacrifices, study suggests"](https://www.yahoo.com/news/neolithic-women-europe-were-tied-191955892.html). *LiveScience*. Retrieved 2024-04-10 – via [Yahoo! News](/source/Yahoo!_News).

1. **[^](#cite_ref-Fineschi_21-0)** Fineschi, V. (March 1998). ["Typical Homicide Ritual of the Italian Mafia (Incaprettamento)"](https://journals.lww.com/amjforensicmedicine/abstract/1998/03000/typical_homicide_ritual_of_the_italian_mafia.17.aspx). *[The American Journal of Forensic Medicine and Pathology](/source/The_American_Journal_of_Forensic_Medicine_and_Pathology)*. **97** (1): 87–92.

1. **[^](#cite_ref-22)** Ludes, Bertrand; Alcouffe, Ameline; Tupikova, Irina; Gérard, Patrice; Tchérémissinoff, Yaramila; Ribéron, Alexandre; Guilaine, Jean; Beeching, Alain; Crubézy, Eric (2024). ["A ritual murder shaped the Early and Middle Neolithic across Central and Southern Europe"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006212). *[Science Advances](/source/Science_Advances)*. **10** (15). [doi](/source/Doi_(identifier)):[10.1126/sciadv.adl3374](https://doi.org/10.1126%2Fsciadv.adl3374). [PMC](/source/PMC_(identifier)) [11006212](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006212).

## Sources

- Ohlenkamp, Neil (2006). [*Judo Unleashed*](http://judounleashed.com). McGraw-Hill Education. [ISBN](/source/ISBN_(identifier)) [0-07-147534-6](https://en.wikipedia.org/wiki/Special:BookSources/0-07-147534-6). Basic reference on judo choking techniques.

Authority control databases International GND National United States France BnF data Israel

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Adapted from the Wikipedia article [Strangling](https://en.wikipedia.org/wiki/Strangling) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Strangling?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.