There are three variants of this torture. In the first, victims have their arms tied behind their backs; a large rope is then tied to the wrists and passed over a pulley, beam, or a hook on the roof. The torturer pulls on this rope until the victim is hanging from the arms. Since the hands are tied behind the victim's back, this will cause a very intense pain and possible dislocation of the arms. The full weight of the subject's body is then supported by the extended and internally rotated shoulder sockets. While the technique shows no external injuries, it can cause long-term nerve, ligament, or tendon damage. The technique typically causes brachial plexus injury, leading to paralysis or loss of sensation in the arms.