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Definitely a lot of defenses to it, I mean, armbar for one. And if you can control the top man's hips and posture, he can't really do so much with it.I could see a can opener doing damage if bottom guy is hellbent on finishing a leglock, but I've honestly never even considered them from anywhere other than stalemated in closed guard. Maybe I'm off but I feel like from almost any other position (assuming he's focused on defending the can opener), bottom guy has room to move and can shut it down. But even inside closed guard, there are defenses bottom guy can do as long as he reacts early enough.
But I've always considered it a bit of a dick move and would never even attempt it on someone much smaller or weaker. Only on guys at least same size and if they're stalling with closed guard.
So what about the full nelson or reverse nelson? Would you think a flexible neck would essentially neutralize the damage from those? The reverse nelson always looked scary as heck to me.