Anatomy for Rope Bondage

Key
X = vulnerable area of nerve

____ = area where nerve runs more superfcially

- - - - = area where nerve runs more deeply (protected by overlying muscles)

Dotted areas = places where you will feel sensation corresponding to the same color- coded nerves.

RADIAL NERVE (red areas)

• Helps extend the wrist
• Provides sensation on side of thumb and back of hand/wrist
• Damage to upper portion of nerve can cause wrist drop; damage to lower portion of nerve afects sensation only

ULNAR NERVE (blue areas)

• Helps ring and pinkie fngers move from side to side and fex
• Provides sensation on ring and pinkie fingers and part of palm
• Damage at wrist limits side-to-side finger movement; damage at elbow also limits fexion of these finger

MEDIAN NERVE (green areas)

• Helps flex thumb, index finger, and middle finger; helps rotate palm downward
• Provides sensation for most of palm and thumb, index finger, and middle finger
• Damage at wrist limits ability to make a fist

“Rope play is edge play.”

This phrase gets thrown around a lot in the world of rope bondage. But what does it mean, and why should you as a rope bottom pay attention?

Rope is a tool that can be used for bondage, just like leather, fabric, metal chains…pretty much anything you can imagine! What makes rope riskier than some of these other materials, however, is how tightly and precisely it can compress and create a shearing force on important parts of your anatomy (more on those concepts below). If rope is improperly placed or tensioned over a nerve, it can cause temporary or even permanent damage to that nerve and the parts of the body connected to it.

Te goal of this chapter is to make you much more aware of your own anatomy so that you can communicate better with your rope partner(s) to prevent and mitigate injuries.

Nerves 101

Let’s start with some basic information about nerves. Nerves are like long, thin wires connecting your brain to all the diferent structures in your body—your skin, organs, muscles, joints, etc. Nerves are made up of bundles of microscopic fibers that are each individually wrapped in a protective coating, called myelin. Tese bundles are then bound together by layers of connective tissue to make up the larger nerve, which can in some cases be seen by the naked eye. One of the things about nerves that is often overlooked is that each large nerve actually contains very small blood vessels. Tese vessels run the length of the nerve, bringing the fibers oxygen and nutrients and removing toxins. Compression of a nerve can interrupt that blood supply.

Nerves in the arms and legs (the ones that we care the most about in rope bondage) fall into two categories: sensory and motor. Sensory nerves carry information about stimuli like temperature, vibration, pressure, and pain from the periphery to the brain, where it can be interpreted. Yes, there are specific fibers that carry pain signals, and they are some of the most easily damaged components of a nerve! An example of sensory nerve damage is not being able to feel an area on the front of your thigh, although you can still move the entire leg just fine. Motor nerves are involved in movement - they carry instructions from the brain out to muscles in the body, telling them to tense or relax. An example of motor nerve damage is wrist drop, when the wrist cannot move on its own into an extended position - it hangs limply when the arm is parallel to the floor.

Both sensory and motor nerves are very important in our day-to-day lives, and the loss of either sensation or movement in a part of our bodies can be anything from minor to devastating. Imagine your job involves typing on a computer, and for three weeks after a rope session you are unable to feel what is happening in your finger-tips. Or perhaps you cannot lift your dominant hand for three days, and you have an art project due in a week. It is very important in rope bondage (or any bondage for that matter) to understand the risks and decide what level of risk you are comfortable with. If an injury like those described above would be unacceptable to you, you must take extra caution in preventing it!

Preventing Nerve Injury

OK, so nerves are important. How do they actually get injured in rope?

Nerves can be damaged by rope in two ways: compressive force (for example, a wrap is too tight or on for too long) and shearing force (for example, when a wrap moves across a limb under pressure, such as during transitions in suspension). Think of a nerve like a bundle of uncooked spaghetti strands wrapped in plastic wrap. If you squeeze it hard enough, some of the pieces will break. If you hit it with something, more pieces will likely break. These are both types of compressive forces. Now, consider what would happen if you grip the opposite ends of the bundle with both hands and twist in opposite directions. Most of the pieces will break! I his is a shearing force, and it is by far the most damaging thing to a nerve.

When you are in rope, pay attention to the tension of each wrap (its looseness or tightness). If you notice a wrap is uncomfortably tight, consider its position - is it in a dangerous area where a nerve could be damaged? We’ll talk more about where those trouble zones ar e shortly. If you are doing a dynamic suspension or being moved around actively in rope, pay attention to the rope in those trouble zones. Traction or pulling along those wraps may create a risky shearing force, so you need to monitor that limb closely.

This sounds great in theory, but how do you know if there is a problem?

We will start with sensory nerves. Symptoms of sensory nerve damage usually come in phases. First, most people will notice a tingling or burning sensation in the part of the limb that is affected by the nerve in danger. Sometimes the area will also feel cold. This is typically a very specific feeling in terms of location - a couple of fingers, one side of a leg, etc. Sometimes you will simply lose sensation on an area of the skin without any tingling or burning at all.

If the wrap causing the issue is not adjusted, this can progress to numbness or complete loss of sensation. Tingling and burning usually improve as soon as the wrap is adjusted, but numbness can take minutes, hours, even days or weeks to improve.

When your arms are bound, it is helpful to run your thumb over the tip of each of your fingers periodically to see if the sensation experience is the same for all fingers. You should also run your index finger along the back side of your thumb. If the sensation varies from one finger to another, this may mean that a nerve is in danger, and you should consider communicating the specific information to your rigger. For example: “I am starting to feel tingling along the back of my right thumb.” Your rigger can then look at your wraps and deduce where an adjustment should be made.

Sensory nerve issues are more common and in most cases less debilitating. Quick adjustments by a millimeter or two might be all that is needed, and the scene can progress. They are also usually the first things you will notice. Motor nerve issues are more concerning, however.

Motor nerve fibers are thicker and more resistant to damage, so if you are developing weakness, it was likely preceded by sensation problems along the same large nerve bundle. Weakness typically starts as a sluggish feeling, like you are trying to move a limb through molasses. This will then progress to the inability to move at all. For example, you try to extend a hand at the wrist, but nothing happens. This is something you should communicate with your rigger immediately, and it is a reason to consider stopping the scene to fix the problem. If you are so numb that you cannot tell if your hand(s) or fingers are responding to your brains commands, ask your rigger to look for you.

Many bottoms and riggers will develop specific systems to check on sensation and motion. One of my favorite examples is a riggers taking the bottoms hand and giving it a squeeze - if you can feel the squeeze and the riggers touch equally on all your fingers, then sensation is OK. If you can squeeze back and pull against the riggers hands by extending yours at the wrist, then the motor function in your hand is OK. It is a good idea to test both wrists at the same time. Extension of the wrist, opening and closing the fingers, and squeezing are the functions that you need to be sure work in your hands while bound. If your hands are bound behind your back, you can extend your wrists so that they press against the small of your back - even if you are a little tingly in the hands, you will feel the pressure of your hands against your back.

Circulation

When people teach about the risks of rope bondage, they tend to focus on nerve damage. But circulation issues can also cause numbness, sluggish movement of a limb, and sometimes even dramatic color changes in the skin. Sometimes it can be hard to tell the diference between a problem with circulation and with nerves. We will review the basics of the peripheral circulatory system to help clarify these issues—it’s not actually as hard as it might seem!

Arteries carry blood away from the heart and out to the periphery. There, they spread out into tiny little capillaries where the oxygen and other nutrients that the blood is carrying can be delivered to their targets—muscles, skin, organs, etc. After the important contents of the blood have been delivered, waste products from the tissues are then absorbed through the thin walls of the capillaries. Capillaries then feed into larger veins, which collect the blood from the periphery and bring it back to the heart.

Arteries have thick muscular walls that make them harder to compress. They also tend to run deeper inside our limbs and be more protected by muscle tissue. This usually protects them during bondage. If an artery is compressed to the point of blocking blood flow, the limb downstream from it will turn white. It will go numb fairly quickly as well. This is a bad sign, as lack of blood flow can cause fairly rapid damage to nerves and muscles. You have a matter of a minute or so to adjust or loosen the wrap on a white limb. Once a wrap is shifted or loosened, you will notice the limb start to get pink again, and sensation will slowly but steadily return. Fortunately, you will almost never see or hear of issues from compressing arteries in rope bondage!

Veins have thin, easily compressible walls, which makes them much more vulnerable. Some veins run deep between layers of muscle, but many are quite superficial. When ties are placed on your arms, you will often notice the veins in your hands start to plump up and become more prominent. Blood in the arteries is still able to get past the rope into your hands, but the pressure from the rope on your veins is just enough to trap it there. This will cause blood to gradually pool in the arm, and the tissue will start to swell. This process tends to create a wide array of color changes in the skin - red, blue, and purple are the most common. If blood is trapped there long enough and there is enough pressure on the limb, it can even cause capillaries to burst and red speckles will form within minutes. The good news, however, is that at least all your tissues are getting the nutrients they need survive, because fresh blood keeps pumping in. Color change does not necessarily mean there is a problem!

With veins, you usually have at least 10 to 15 minutes of significant compression and blood-trapping before you need to worry about any damage. There is a caveat, however. When you have significant blood-trapping in a limb, you will tend to go diffusely numb (rather than in specific smaller areas like you do with nerve compression). If you are completely numb from circulatory issues, you cannot accurately perform sensory checks to be sure your nerves are safe. Additionally, if your movement is sluggish from blood-logging of the muscles, you cannot reliably test your motor function. These are reasons to consider loosening, adjusting, or removing a tie.

Te Nerve Pathways

In the diagrams throughout, you can see each nerve outlined on the body. Te nerves are drawn with a solid line where they are more superfcial and with a dotted line where they are buried deep- ly underneath layers of muscle. Te most exposed and therefore most vulnerable area of each nerve is marked with an X. Bear in mind, however, that every person is diferent and there are many possible variations. It is important to explore your own body to see where you are most sensitive. Tere are also diagrams with dotted zones. Tese are color coded to match the nerves and show the sensory areas to correspond to each nerve. Damage to the nerve anywhere upstream from the dotted area may cause numbness, tingling, or the sensation of temperature change in that zone.

In this chapter we are focusing on the nerves of the upper extremity, as these are easily irritated and injured in rope bondage. The three most important nerves to consider when binding the upper half of the body are the radial nerve, the ulnar nerve, and the median nerve. All of these nerves carry both motor and sensory fibers above the elbow, but from the wrist and below their functions are primarily sensory. Certain common ties, like the takate-kote (box tie) can place these nerves at risk, but if you learn your body and how these nerves run, you can better avoid or quickly diagnose and correct problems.

Here is an example. Lets say you are bound in a box tie, and after five minutes your left pinkie finger starts to tingle and burn. Where might the problem be? First, you need to figure out what nerve is involved. In the images, this nerve is vulnerable in the armpit, the elbow, and the pinkie side of the wrist. Now you assess the tie that you are in. Are there upper cinches running through your armpit? If so, is the one on the left causing compression? Is the wrist cuff too tight? Can you adjust your wrist slightly to avoid putting pressure on the nerve? You can ask your rigger to dress your wraps, to adjust the location of the cinch or the wrist cuff, or perhaps even release your wrists if the sensation is worsening. Practice running through scenarios like this with a partner so that you can quickly identify trouble areas. The images will help you see where the nerves travel when the arms are in a box tie position.

Treatment for nerve injuries is constantly evolving and is beyond the scope of this book. If you’ve been injured, it’s highly recommended that you seek the attention of a medical professional. (You could even do your own research to be armed with the latest information to discuss with your doctor.) Also, it’s good to have an emotional support system, as getting injured can cause you to blame or doubt yourself and your abilities, or otherwise feel bad about yourself. Having support from your partner, other rope bottoms, friends, or even just online can help alleviate those feelings.