When rope presses too deeply into a person, it can disrupt the flow of blood or damage nerves. This can happen if the rope itself is too tight or if too much pressure is being added to a person’s body using rope.

Compressing blood vessels in such a way that impacts circulation is typically not a major concern. Unless a person has a complicating condition related to blood (ask them about this), the flow of blood can usually be reduced or even cut off for quite a while without issue; 30 minutes or so. That said, it is not comfortable, so fix this issue as soon as you can; you just don’t need to drop everything to deal with it on an emergency basis.

Compressing nerves, on the other hand, is something that must be dealt with immediately. This typically presents as a change in a person’s sense of touch (perhaps the skin on some of their fingers goes numb or feels strange in some other way) or as a loss of strength or control of some part of the body (for example, “wrist drop”, when a person cannot lift their hand). Nerve compression can result in nerve damage in a very short period of time — minutes or even seconds, depending on type and severity. Nerve damage can take months or years to heal, and it some cases it may never fully heal.

Check out Nerves & Circulation for more information about this crucial area.

Prevention

Learn where nerves typically travel close to the surface of the skin and therefore may be more vulnerable to compression. Particularly risky areas include the wrist, the outside of the upper arm and elbow, the armpit, and the inside of the leg and crease where the leg and waist meet near the groin. We’ll talk much more on this in the Nerve Compression section below (p.###). We will also point out specific risks in the tutorials themselves, along with methods to reduce those risks by managing how tightly the rope is tied or the placement of rope — or both.

Remember that changing the bottom’s position after the tie is complete can change the tightness. What was an acceptable tightness in one position may be too tight if you then move the person into a different position. It is best to have your partner get into the general position you want them in as you are tying them.

Learn how to test for changes to touch sensitivity and strength. Teach your partner how to do those tests themselves and have them build them into habits. There’s more on this in Major Indicators of Compression, in the Nerves section below.

Check out Nerves & Circulation for more information about this crucial area.

Treatment

Pre-injury:

If you or your partner detects that an issue may be occurring — for example, the bottom’s thumb or forefinger start to go numb — take action immediately.

Move the band of ropes causing the compression; even 1 inch or so can make a difference. If the issue does not resolve in 15 seconds, remove that element of the bondage.

Build quick releases, or “outs”, into your bondage. For example, use a Slipped Somerville Bowline  as part of a Box Tie so you can release the wrists in just seconds, thereby relieving the pressure on the upper arms.

If the issue seems severe, and you cannot release them quickly, cut the ropes off. If you need to cut ropes, be sure your bottom won’t fall and injure themselves in a different way!

If an injury occurs:

If there is intense pain, seek medical attention immediately.

If a lower-severity injury occurs, there is little that can be done at home to fix it.

Anecdotes suggest that if you know the specific site of the issue, it can be helpful to rest it for a few hours then resume gentle movement of it the next day or so. DO NOT try to stretch or massage it to try to get things back in place. That doesn’t work with nerves and can cause further damage. Keep in mind that the location of the injury may not be the location where the symptom is felt. For example, when the radial nerve in the upper arm is compressed, it is often felt as numbness in the thumb or forefinger. Read Major Indicators of Compression in the nerve section below for more information.

Keep in mind that nerve damage can be cumulative. A little today on top of unhealed damage from the week before will just keep building.

If you are still feeling symptoms after 2-3 days, consult a medical professional.