The person on his/her shoulders is the "attacker" and may use any means possible of separating the other team or knocking them to the ground.
A similar Japanese game called kibasen (騎馬戦, literally "cavalry fight") is commonly played as part of an annual sports day event at elementary and junior high schools.
In it, a team of four competitors work together, with three carrying the fourth, who wears a bandana (hachimaki) or hat.
In recent years some schools have removed physically demanding events such as the kibasen from sports day programs due to the risk of serious injury.
In a 2003 incident a high school student in Fukuoka Prefecture was left quadriplegic after falling from his teammates' shoulders.