As a karate instructor, novelist, and former journalist, I like to keep my combat damage accurate. I worked with physicians for 19 years, and they were always great about answering questions for the crazy writer. Rather than making up more myths, I’ve checked with people who’ve taken care of patients who are on the receiving end of this kind of stuff, so you don’t have to.
The one arm back choke
Some writers seem to think this is the pinnacle of all attacks, and that there’s no way to get out of it. This is, of course, rubbish. I know several ways to escape this hold, depending on where in the attack I react. The first throw I ever learned was against this attack. If you have a character who has trained in combat, she should have a response for this attack (yes, Babe of Nine, I am scowling at you).
Here’s a video with three defenses.
The next problem with this attack, or hold, as many writers use it, is that most people don’t understand how it actually works. This particular attack has the potential to be fatal, very quickly, and about every other year you’ll hear about a bouncer or police officer accidentally killing someone while restraining them with this hold (which actually makes it a poor choice for a hold). There are two ways this choke works.
- If the attacker puts her forearm against your windpipe, at the front of your neck, your air supply is cut off. You have about as long as you could hold your breath before you lose consciousness. This varies from person to person, but it’s not unreasonable for someone to go more than a minute without breathing. If the hold isn’t as tight, you can get enough air to stay conscious. Also worth noting, the human body generally needs more oxygen if it’s been active and if it’s pumped up on adrenaline from activity or fear.
- If the attacker’s forearm and upper arm are against the sides of your neck, squeezing your neck between, with her elbow in front of your windpipe, the pressure is on your carotid arteries. In case anatomy isn’t your forte, this is the oxygen supply to the brain. Fully obstructed, you have ten seconds or less before loss of consciousness. Since this seems too fast, most people think that the person being choked is faking, and they don’t let go. Without oxygen, brain cells start to die off pretty fast.
Here’s a video showing the mechanics of both versions of this choke.
Palm heel/punch to the nose
Who grew up being told this was a potentially lethal attack? Yeah, it’s okay. I did, too. This will not actually shove bone shards into the brain of the person who gets hit. If, your protagonist happens to be a super hero, with super strength, it is theoretically possible to have a some skull shard and brain interaction, but because this is the frontal lobe, there’s pretty good potential for recovery, especially in our modern society. It would count as a traumatic brain injury, so the recovery may or may not mean returning to exactly the same state (personality or functionality) as before.
Throwing random knives
Most knives are weighted appropriately for use in the kitchen and suck for throwing. Grabbing a random knife and throwing it makes a great distraction, but odds are good it will miss the target or hit it with a non-stabby part (the handle, the back or side of the blade). Knives designed for throwing tend to be small and made of solid construction. They look incomplete or highly utilitarian.

You can balance a throwing knife on your finger at it’s middle point. Having equal weight at both ends means it will throw evenly. On a side note, there are two dominant philosophies on knife throwing. The one that shows up most often is that you hold the knife from one end to throw it, and it rotates through the air before plunging pointy end in at the target. The other option is to hold the knife from the center and throw it straight, with no rotation, like a very tiny javelin.

Being pinned under an attacker
Like the one arm back choke, many writers think it’s impossible to get out of this position. To be fair, this seems to get taught less, so it’s forgivable if a character who can fight doesn’t have an option for this. That said, most people with training have options for when they don’t know a technique for a specific grab. That’s what loosening moves (punches, kicks, elbow and knee strikes, and biting) are great for. A person with no training may still be able to get out of this, but our media frequently pushes the message that it’s impossible, and it can be tough for some people to break that conditioning in a crisis.
Here’s a video showing two forms of this attack and a good counter response.
The bipedal roughly human-sized attacker is too big/heavy to throw
No. Just. No. Well designed throws are actually easier when your opponent is taller and heavier than you. The hardest person to throw is one who is shorter but heavier. I can’t speak for judo throws over the back or shoulder, but for many forms of martial arts, throws involve getting under someone’s center of gravity and tipping them over. This can be done by sweeping someone’s feet out from under them (leg sweeps), getting in close and compromising their stance, or by pulling them off balance (the one arm back choke throw above is an example of this).
Head injuries
Head injuries are so badly handled in fiction. A concussion is what happens when your brain bumps against the inside of the skull hard enough to bruise it. It’s considered traumatic brain injury. The severity of a concussion is based on the symptoms following the injury, not how severe the injury initially seemed. Loss of consciousness isn’t necessary for a concussion, though this is usually associated with more severe damage to the brain, and often more severe symptoms. Post concussion syndrome consists of an enormous list of symptoms. Your exact symptoms may seem random, but are related to the part of your brain that was injured. Post concussion syndrome can last anywhere from a few days, to a few months, to forever, regardless of the initial perceived severity. Some effects of a concussion don’t show up for months or years, and a recent study found that some visual changes (specifically refractive errors) may occur up to two years after a concussion.
My son hit the floor with his head in first grade. He never blacked out. He remembers everything. He ended up with blurred vision for a couple of weeks and seven weeks of post-concussion syndrome that consisted of random and uncontrollable anger outbursts (that scared him), general irritability, fatigue, and headache. It’s possible that the amblyopia he developed a year later is a result of the concussion.
If your character can go from knocked out to perfect fighting form in minutes, you need to have a justification (Buffy had amazing healing powers, Hobbits are resilient to head injuries, etc), so your reader doesn’t think you’re an idiot.
Snapping spines
This would be the rapid head twist that we have all come to understand as breaking someone’s neck. It shows up in movies and TV a lot and tends to be accompanied by a bone crunching sound. This bugs me less than other things on this list, because the end result is pretty much accurately portrayed. It’s just that this doesn’t break someone’s back or neck in the way most people understand it to. This severs the spinal cord at the base of the brain stem, the same mechanism for the fatal single punch incidents that show up in the news. As my doctor friends have explained, you’re dead before you hit the ground, because the body is no longer receiving any communication from the brain. Spinal cord damage lower down the neck or back is survivable because the body still gets the message to breathe and keep the heart beating.
All this said, it’s still okay for a character who should know what she’s doing to mess up on a defense. In life threatening situations, we don’t always make our best choices, and I don’t believe in victim shaming or blaming, even for fictional characters.
However, if your character realistically should know a way out of a situation, but doesn’t use it, you’ll need to address it in some fashion for the character to stay believable. It could be something as simple as she felt off or the adrenaline was too much and she wasn’t thinking clearly. It could be that she was taking the safety of others into consideration. It could be that her opponent knew a counter and was faster at executing it. There are lots of great excuses that allow you to address this without it becoming a major plot coupon. Use one and move on with the story.