Who Can Be Suspended? - bondage basics

Being larger-bodied does not exclude someone from being suspended. That said, I think making a general statement about anyone being able to be suspended is potentially dangerous, for two main reasons: rigger skill and health issues.

blissy and Rocket. Bondage by Rocket.

The first of these issues is rigger skill. A rigger is a person who also gets to have limits. Limits - they’re not just for bottoms! Those limits may be knowledge-based (“I don’t know how to suspend larger-bodied people”) or preference-based (“I prefer to suspend only 100-pound bondage models”). Of course, stating one’s own skills honestly is quite different from saying, “It simply cannot be done!” and having a personal preference is quite different from being a fat-shaming douchebag. There are unique skills involved in suspending a larger-bodied per- son—not any rigger can or should suspend a bottom of any body shape. Some of that skill is relatively simple (generally, more wrapping turns are called for), but some is very specifc and specialized.

There are safety concerns that extend to the rigger as well. If a larger-bodied suspension bottom needs to come down now, can the rigger partially support their weight while getting them down quickly and without injuring themselves? I think we can all intuit that this is more challenging with a 200-pound bottom than a 100-pound one. Having a spotter (another pair of hands to help should it be needed) and/or using an appropriate pulley system (which adds complexity and another potential point of failure) may be all that is required to mitigate this, but it’s another area where additional expertise is required.

Moving on to the health aspect - being larger-sized doesn’t exclude you from being suspended, but neither does being smaller-sized mean you can do all the suspensions! There are actually potentially increased risks at the other end of the weight spectrum. Most notably, very thin people are at higher risk for acute compression nerve injury. With regards to assessing general health, fitness is a more important factor than weight: “Data from a 2009 study showed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out.”

A focus on ftness is very relevant to rope, because here’s something no one told me before I got suspended for the frst time: Being suspended can be very strenuous! Dynamic sequences involving drops and position changes, or especially challenging suspensions (four wrapping turns around your ankle and up you go!) require a high level of fitness and body awareness. Which is not to imply that dynamic suspensions are more dangerous than static suspensions - in some cases they are safer, but often they do require more athletic ability. The best parallels I can think of are yoga or circus arts training (bar, hoop, silks). Are you healthy and fit enough, at whatever size, for those activities? You may need to build fitness before being able to partake in the most strenuous/dynamic suspensions.

The fitness needed and strain involved in being suspended are eminently scalable; it is not an all-or-nothing either-you-can-do-it-or-you-can’t activity. If you want to do strenuous, dynamic suspensions (and there’s no reason you have to; they’re not everyone’s kink), be realistic with your rigger and spend some time training. Rigging involves practice, skill, and training - a suspension bottom would be well served by developing or honing rope bottoming skills like core strength, balance, and body awareness!

Everything we do in kink (and, you know, life) has risks. Specific health conditions increase those risks, and at some point those risks outweigh the rewards of a given activity and we sit back and say, hmmm, maybe it’s not such a good idea to do that. If you have frequent seizures, you aren’t permitted to drive. If you are on blood thinners, your doctor will likely advise you not to go downhill skiing. Likewise, there’s some kinky shit that you probably shouldn’t do if you have certain health conditions. Someone with poorly controlled diabetes probably shouldn’t bottom for bastinado (caning the feet), and someone on Coumadin (a potent blood thinner) shouldn’t bottom for play piercing. This is simply about being rational regarding the risk-vs.-reward ratio of any given activity.

That said, here is a summary of conditions that at the very least require extra caution, awareness, and expertise (from both rigger and bottom) for suspension. In some cases these issues may make certain suspension positions particularly (and probably unacceptably) risky, or may mean someone shouldn’t be suspended at all - these conditions all exist on a continuum, and evaluation needs to take into account the entire picture of a person’s health and fitness, not just a single diagnosis.

• Conditions that cause significant neuropathy (nerve damage and impaired sensation), impaired circulation, or impaired lymphatic drainage require caution with any bondage, and in many cases may exclude the affected limb(s) from load-bearing bondage. Such conditions can include diabetes, lupus, stroke, mastectomy, lymph node removal, carpal tunnel syndrome, and Raynaud’s disease.
• Serious respiratory issues (severe asthma, COPD, etc.) - these are especially a problem for chest-heavy ties and suspension positions like facedown or inversion.
• Heart issues (CHF, arrhythmias, valve abnormalities, etc.)
• Diabetes that is severe or poorly controlled— this causes increased risk of peripheral vascular disease, or poor blood flow to the legs, and peripheral neuropathy. I think it is wise to avoid load-bearing lines on the lower extremities of someone who has peripheral vascular disease, and you may have to base this assessment on risk factors (diabetes, degree of diabetic control).
• Joint problems (this depends on the intended suspension, of course).
• Clotting abnormalities (hemophilia, taking Coumadin or other potent blood thinners, etc.) - I would not suspend anyone in this group, but others may have a different risk assessment.
• Aneurysms - cerebral aneurysms are a particular concern for inversion; aortic aneurysms are very high risk in general. Risk increases when combined with diabetes and/or obesity.
• Hernias
• Eye problems (conjunctivitis, glaucoma)— especially an issue for inversions
• Spinal injury
• Bone weakness (severe osteoporosis, osteogenesis imperfecta)
• Uncontrolled high blood pressure
• History of gastric bypass surgery - likely means the person should not do inversions. And be extremely careful of putting pressure on the abdomen with rope.
• Pregnancy
• Skin integrity issues (like long-term prednisone use)

This is not a comprehensive list! If you’re comfortable being “out” to your doctor, asking them if you’re healthy enough for suspension bondage is an excellent way to get a personal check. If you don’t feel you can be out to your doctor, you might ask whether you are healthy enough for strenuous yoga and rock climbing, which have some parallels with suspension bondage.

Inversion requires special consideration, and there is actually quite a bit of literature specific to this topic - on the use of “inversion tables” to treat back pain and on the safety of various inverted yoga poses. A few things happen when you’re inverted— for one, the weight of your abdomen (including organs and adipose tissue) presses up against your diaphragm, making it harder to breathe. Your in-trathoracic pressure is increased (especially if you strain or hold your breath while inverted, which us perverts are known to do), as is your intracranial pressure. Blood pressure is increased.

Common contraindications listed for inversion include high blood pressure, glaucoma or other eye problems, pregnancy, cardiovascular disease, diabetes (I would add that degree of diabetic control is the key here; some diabetic people can do inversion and some probably should not), and ear or sinus infection. As a side note, most articles on yoga inversion I researched also listed menstruation as a contraindication for inversion. The only reason I could find for this had to do with beliefs about chakra energy flow rather than anything I would consider a medical contraindication.

Suspension can be amazing, sexy, and fun - but it’s also one of the riskier things we kinky perverts do. It’s edge play and is not for everyone - top or bottom. I hope you can use this information to help you make a more accurate risk aware assessment... instead of believing bullshit.