This typically happens if a person is contorted into a position that is not typical for them, if they are held in a position for longer than their body can handle, or as the result of an unexpected movement like a fall. The knees, shoulders, and back are particularly vulnerable.

It may be several hours or even the next day before such an injury is felt. These injuries also can be cumulative. A small injury today adds to a small one last week that hasn’t yet healed, which added to one before that — you see the problem.

Prevention

During negotiation, discuss the bottom’s physical capabilities. Use techniques that allow you to work within your partner’s comfort zone. For example, if your partner cannot assume a Box Tie position, don’t try to force them into one; use an Adjustable Box Tie technique instead. Both Top and bottom need to build experience with regards to what works and what doesn’t for that particular bottom.

Tops: During a scene, move in a careful and controlled manner. Help the bottom to do so as well.

Bottoms: If you want to be tied in a certain position, work on being able to assume that position when you are not tied. Strength and flexibility training can help you to work towards a desired position safely.

Treatment

If there is intense pain along with immediate and significant swelling, seek medical attention immediately. If a limb or muscle stops working, or you hear a popping sound like a joint coming out of place, seek medical attention immediately.

If an injury is less severe, treat it the same way you would normally treat a bruise, strain, or sprain using the well-known RICE method (in the Bruising section above).

As always: Listen to your body. Seek medical attention if you believe you might need it.