A chokehold is a restraint technique that compresses the neck to restrict either airflow or blood flow to the brain. Despite the single term, there are two fundamentally different types of chokeholds, and the distinction between them matters enormously for understanding the risks involved. One targets the windpipe; the other targets the arteries on the sides of the neck. They work differently, feel different, and carry very different levels of danger.
Air Chokes vs. Blood Chokes
The most important thing to understand about chokeholds is that they fall into two categories based on what they compress.
An air choke (also called a respiratory choke or tracheal choke) applies direct pressure to the front of the neck, compressing the windpipe and restricting the ability to breathe. This is the type most people picture when they hear the word “chokehold.” It’s painful, slow to take effect, and carries significant risk of structural damage to the throat. Air chokes are widely considered the more dangerous of the two types and are discouraged or outright banned in most law enforcement and sporting contexts.
A blood choke (also called a vascular restraint or carotid restraint) compresses the carotid arteries on the sides of the neck without pressing on the windpipe. By cutting off blood flow to the brain, a properly applied blood choke can cause unconsciousness in roughly 10 seconds. A study published in the Journal of Applied Physiology found that subjects lost consciousness at an average of 9.5 seconds during a controlled vascular neck restraint. The person being choked may not feel pain or breathing difficulty before losing consciousness, which is why this type is considered more predictable in controlled settings.
Where Chokeholds Are Used
Chokeholds appear in three main contexts: combat sports, law enforcement, and unfortunately, interpersonal violence.
In martial arts and combat sports like Brazilian jiu-jitsu, judo, and mixed martial arts, chokeholds are core techniques. The rear naked choke is one of the most well-known submissions. Applied from behind an opponent, the attacker wraps one arm around the neck, positioning the crook of the elbow over the windpipe (to avoid compressing it), while the forearm and bicep squeeze the carotid arteries on either side. The name “naked” simply means no clothing or uniform is used to create the hold. In judo, this technique is called hadaka jime. In Brazilian jiu-jitsu, it’s known as mata leão, which translates to “lion killer.”
Other common chokeholds in grappling include the guillotine choke, triangle choke, and various collar and lapel chokes that use the opponent’s uniform for leverage. Competition rule sets vary widely. Some tournaments allow a competitor who has been choked unconscious to return to competition after a 5 to 10 minute break. Certain organizations permit choke techniques in divisions for children as young as four years old, though the risk profile in children is not well studied.
In law enforcement, the use of chokeholds has become one of the most contentious issues in policing policy. Many departments historically trained officers in vascular neck restraints as a less-lethal force option. The Minneapolis Police Department, for example, classified a chokehold (pressure on the front of the neck) as deadly force, while classifying a neck restraint (pressure on the sides of the neck) as non-deadly force. That distinction collapsed in public discourse after several high-profile deaths during police restraints.
Medical Risks and Injuries
Even a brief chokehold can cause injury, and the risks scale with the type of choke, the force used, and how long it’s maintained.
Fractures of the hyoid bone, a small horseshoe-shaped bone in the throat, are one of the hallmark injuries of neck compression. Hyoid fractures occur in roughly 50% of manual strangulation cases. This bone is fragile and sits in a vulnerable position, and its fracture can lead to swelling in the airway, difficulty swallowing, and in serious cases, bleeding or infection. Late complications from throat injuries include persistent difficulty swallowing, abnormal breathing sounds called stridor, and, rarely, damage to blood vessels in the neck such as pseudoaneurysm of the carotid artery.
Beyond the throat itself, restricting blood or oxygen to the brain creates neurological risk. Research on women who experienced strangulation during intimate partner violence found that those who lost consciousness during the event reported significantly higher levels of traumatic stress symptoms years later. Vision problems and difficulty concentrating were also more common in those who experienced altered consciousness during strangulation. The average time between the strangulation event and the study interviews was nearly nine years, suggesting these effects can become chronic. While this research focused on violent strangulation rather than controlled sporting chokes, it highlights the potential consequences any time blood or oxygen to the brain is interrupted.
Positional asphyxia is another risk during restraint situations. This occurs when a person’s body position prevents normal breathing and they cannot reposition themselves. Hyperflexion of the neck, where the chin is forced toward the chest, is the most frequently reported cause of airway obstruction in these cases. Positional asphyxia is distinct from a chokehold itself but often occurs alongside physical restraint, making it a contributing factor in restraint-related deaths.
Legal Status in the United States
Federal regulation of police chokeholds remains limited. Executive Order 13929, signed in 2020, requires state and local police departments seeking federal funding to certify that their policies ban chokeholds except when deadly force is authorized. That order applies specifically to air chokes and does not address blood chokes. Congress has not passed a federal law explicitly regulating police chokeholds, despite multiple bills introduced in 2020 and 2021.
At the state level, the picture is uneven. As of 2022, only 16 states and Washington, D.C. regulated police chokeholds through statute, roughly one-third of all states. Six states have enacted total bans on police chokeholds in all circumstances: California, Massachusetts, Nevada, New York, Utah, and Vermont. Another group of states, including Connecticut, Delaware, Indiana, Minnesota, New Hampshire, and Oregon, allow chokeholds only when deadly force would otherwise be justified.
The scope of these bans also varies. Ten states ban both air and blood chokes by police. Three states, Indiana, Illinois, and Iowa, ban only air chokes, leaving vascular restraints as a permitted technique. Five states have attached criminal penalties to chokehold policy violations, meaning an officer who uses a banned chokehold can face criminal charges rather than just departmental discipline. Several states also require fellow officers who witness an unlawful chokehold to intervene.
Why the Terminology Matters
One persistent problem in public discussion, medical treatment, and policymaking is that the terms “chokehold,” “neck restraint,” and “strangulation” are used interchangeably when they describe different things. Emergency medicine physicians have noted that the misuse of neck restraint terminology directly affects both medical treatment and public policy. When a patient arrives at a hospital after a “choking” incident, the clinical concern is very different depending on whether the windpipe was compressed or the carotid arteries were squeezed. Airway compression raises the risk of swelling and delayed airway obstruction. Vascular compression raises concerns about blood clots and neurological injury.
In legal and policy contexts, imprecise language can lead to laws that ban one type of chokehold while inadvertently permitting another. The federal executive order’s silence on blood chokes, for instance, means departments can continue training officers in vascular restraints while technically complying with the order’s requirements. Whether that gap is intentional or an oversight depends on who you ask, but it illustrates how much rides on getting the definitions right.