When sitting in a quiet theatre or a packed train, stifling a sneeze by holding the nose and closing the mouth may seem like the courteous option.
However, doctors have warned against the polite practice, after a man ruptured the back of his throat while trying to contain the convulsive explosion of air.
The 34-year-old was admitted to hospital barely able to swallow or speak after pinching his nose and clamping shut his mouth to stop a sneeze. When doctors examined him they also heard strange popping and crackling sounds, which extended from his neck all the way down to his rib cage.
A scan confirmed that air from his lungs had bubbled its way into the deep tissue and muscles of the chest.
In order to let the rupture heal, the man was fed via a tube and hospitalized for seven days.
"When you sneeze, air comes out of you at about 150 miles per hour," Dr. Anthony Aymat, director for ear, nose and throat services at London's University Hospital Lewisham, who was not involved in the case, said to Time. "If you retain all that pressure, it could do a lot of damage and you could end up like the Michelin Man with air trapped in your body."
The report, which is titled "Snap, crackle and pop: when sneezing leads to crackling in the neck," also advises people not to stifle their sneezes.
"Halting a sneeze via blocking nostrils and mouth is a dangerous maneuver and should be avoided, as it may lead to numerous complications," the report concludes.
So free the sneeze, just remember proper sneeze etiquette. The CDC notes that “Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by coughing or sneezing.” To help stop the spread of germs, they recommend covering your mouth and nose with a tissue when you sneeze; if you don’t have a tissue, sneeze into your upper sleeve, not your hands.