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Loss of consciousness associated with Shime-Waza in judo

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Allen E, Singh K, Blach W, Ikumi A, Sasaki E, Illy S, Angioi M, Malliaropoulos N, Migliorini F, Maffulli N. Loss of consciousness associated with Shime-Waza in judo: an exploratory study of coaches’ perceptions, experiences, and practices. Front Sports Act Living. 2026 Oct 23;8:1955805

ABSTRACT


Objectives: Loss of consciousness (LOC) can occur in judo following shime-waza (strangling techniques) in the age and competition categories in which these are permitted. Acute physiological mechanisms of LOC in this context have been investigated, but the consequences of repeated exposure remain uncertain. This exploratory study examined coaches’ perceptions, awareness, and self-reported practices concerning LOC associated with shime-waza.

Methods: A study-specific questionnaire was distributed through judo clubs in the United Kingdom, Greece, and Japan. Eligible adult coaches were invited to report their experiences in dealing with LOC induced by shime-waza, including around its prevention and management. The questionnaire was developed by an expert panel and pilot-tested for usability. We report descriptive frequencies and percentages using item-specific denominators.

Results: Twenty-three male coaches (mean age 47.2 years, range 21-76 years; median coaching experience >20 years) participated, of whom 17/23 were United Kingdom-based. Most reported observing LOC less than monthly or never (21/23) and recalled it more often in competition than in training (15/23). Perceptions of potential consequences, estimated duration, and similarity to concussion were heterogeneous. Eighteen coaches (78.3%) reported awareness of an LOC protocol, whilst perceptions of medical support and post-event behavioural change also varied.

Conclusion: Coaches reported varied experiences and practices regarding LOC associated with shime-waza. The findings are exploratory and cannot quantify knowledge, LOC incidence, or the effectiveness of current safety practices. However, they identify areas where further coach education may be useful, support appropriate safeguards, prompt recognition and assessment of LOC, and support larger studies using validated instruments and exposure-based data.

Keywords: choking techniques; combat sports; judo; loss of consciousness; martial arts.

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