Rope placement to help prevent nerve damage

IMG_5807The radial nerve in the mid upper arm area is a common site of nerve injury for bondage. “The radial nerve is the most frequently injured major nerve in the upper extremity.”29 When you are first learning bondage, or just getting started with suspension, consider completely avoiding tight and/or load bearing ties around this area. Suspension in “box” or “takate-kote/TK” style ties require very specific training and mentoring, and are high risk for nerve damage.

Avoid wrapping any rope that will bear load or be under more than a minor amount of tension around the bottom’s knees, elbows, groin, and armpits. These are places that major arteries, veins, and nerves are near the surface. Studies have documented nerve damage to both the radial and medial nerves caused by blood pressure cuffs positioned too distally on the arm (not high enough, overlapping with the elbow area) – the recommendation of these articles was to be sure blood pressure cuffs are placed proximally (close to the center of the body) enough to avoid overlap with the bend of the arm.5 Try to stay on the “meaty” parts of the extremities.

The lateral femoral cutaneous nerve (LFCN) seems to be the most commonly injured lower extremity nerve. Injury to this nerve causes numbness to a patch of the outer thigh. This most commonly occurs in ebi/”shrimp” positions (where the bottom is bent over, with their torso pressed to their legs) or in face down or side suspensions using a hip harness where rope applies load in the hip area (along the panty line).

You can dramatically reduce compression by having more bondage material against the skin – this is what makes tying up someone’s wrists with a fluffy scarf generally lower risk than restraining them with a zip tie. If you’re using rope, this means making more wrapping turns or thicker rope (8mm is the thickest I would recommend, thicker than that is very difficult to work with).

Often, hands are the first area where the bottom experiences problems. If possible, arrange the bondage so the hands can be easily released without having to undo everything else first.

Next: Pre-disposing factors for nerve damage

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