I recommend this video to look more into OSR philosophy regarding the rules: https://www.youtube.com/live/bCxZ3TivVUM?si=aZ-y2U_AVjn9a6Ua
this post was submitted on 04 Sep 2023
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I don't think that's in the rules. Like, at all. The unarmed fighting style allows you to deal damage to a creature grappled by you, the grappler feat allows you to pin a creature you grappled (which is just fucking useless since both of you become restrained), and you can make a shove attack to push a creature prone. But there's nothing in the basic rules about an unarmed attack that deals damage and knocks the target prone.
The alternatives for flavoring are:
Of course a more permissive DM (like me) could allow you to make a fairly hard athletics check once you have grappled the orc and have two free hands, then resolve it as a 2d6+STR bludgeoning damage attack.
That's actually really clean ways to handle it. I am impressed. Any chance you would have ideas about more basic wrestling moves? Choke hold? Arm bar?
I'm not a wrestler or a wrestling fan, so no clue for most of them. Bars and holds... well, I think the automatic damage to the grappled creature that is dealt with the unarmed fighting style is meant to symbolize damage dealt by various holds and bars, so that would apply here.
Airway chokes are extremely impractical in D&D; every creature can hold their breath for a number of minutes equal to their CON modifier with a minimum of 1, and that means 10 rounds. I wouldn't bother trying to simulate that, just deal the 1d4 damage and move on.
Blood choke... well, that's a different matter entirely. I would most definitely require the grappler feat and the unarmed fighting style for this. Say, you forgo the automatic damage to the grappled target and instead force the target to make a CON save, DC = 8 + your PB + your STR mod. If the target fails, it gains a level of temporary exhaustion (that lasts while you're choking it), if it fails by more than 5 then it gains 2 levels, and if it hits 6 levels it falls unconscious.
I think there's a rules oversight on the choking side of things; while a creature can hold it's breath for a minimum of 30 seconds (if it has a negative con modifier, which hardly ever comes up), the next paragraph of that rule says: "When a creature runs out of breath or is choking, it can survive for a number of rounds equal to its Constitution modifier (minimum of 1 round)." (emphasis mine) So I'd say that there's a difference between holding your breath, and being actively strangled- the latter I'd probably rule as a second opposed athletics check during a grapple instead of dealing damage, which puts the creature down after Con Mod consecutive successes.