Premise: I am not a doctor and what follows is a summary of my personal experience combined with research done and comparisons with other professionals in the sector. It has the sole purpose of better illustrating what may be the risks that can be encountered during a bondage session, be it western style or Japanese, and in no way does it claim to be completely exhaustive. However, if there are inaccuracies or imprecisions, you are invited to let me know.


Talking about safety in bondage is essential because it is unquestionably a risky practice, consequently the more we are aware of the risks we run, the better we can choose if and how to face them.

The spectrum of accidents we can incur when we practice bondage is quite wide and varied. The death case is obviously the most extreme and serious and can depend on various factors, but fortunately, using a little common sense, the probability of it happening can be reduced to a minimum.
On the other side of the spectrum we have accidents which, even if they are minor, can still create problems for those who suffer them. These include: hematomas, friction burns, pressure marks, petechiae and blisters. (a dedicated article will follow, hopefully soon)
Increasing the degree of severity we find: blood pressure, fainting, damage from nerve compression, joint dislocations and fractures.
A fairly transversal risk that can cause minor damage such as bruising up to death, is the risk of falling. It is one of the most frequent and is often caused by carelessness and/or imprudence, for example by leaving the tied person unattended, by neglecting the integrity of the ropes and/or by misusing the suspension lines.

As already mentioned, using common sense can greatly mitigate the risk of incurring these accidents but still does not bring us close to a minimum risk threshold. Knowing how the body and the ropes work can help us lower this potential even if it remains impossible to bring it to zero.


  1. Minor entity.

    Pressure marks from ropes: Many people greatly enjoy seeing the marks left by the ropes on their skin when untied, but for others, it can cause problems. They are an almost essential component when doing bondage and it is very difficult to avoid them, especially if you do suspensions.
    Rope burns, on the other hand, are one of those signs that can be avoided, as they are caused by poor management of the ropes, making them slide too hard on the skin, or even by technical details such as badly closed frictions.
    Blisters and petechiae are usually caused by high tension in the ropes causing blood serum to accumulate under the skin and/or superficial capillaries to burst. If the capillaries rupture is extensive, hematomas can form.
    Hematomas can also be caused by the rope pinching the skin or even by the fingers of the rigger, however they are quite avoidable with a minimum of care.

  2. Medium-high entity.

    Fainting can be caused by various factors, generally there is a tendency to attribute the cause strictly to the person connected as a subjective matter. Dehydration, excessive environmental heat, having eaten immediately before starting the session or having been eating for a while, are all causes that, even individually, can lead to the person tied to fainting. Suffering from low blood pressure can cause fainting and the tied person can only warn the rigger beforehand to avoid running into dangerous situations. The rigger will obviously have to take advantage of the information and adjust accordingly, avoiding using excessive tension, leaving the person tied in positions that can compromise circulation, but also avoiding making too many changes in the suspension set-up. Correct positioning of the strings on the torso can help to avoid this risk. In a torso binding, whether with free arms or not, a rope that is too tight and/or positioned incorrectly at the base of the pectoral can lead to breathlessness and consequent fainting. For example, on the stomach, excessive stimulation of the vagus nerve with the rope can cause this reaction. The same states of fear, pain, severe stress, anxiety, exposure to heat, depending on the subjects, can lead to a sudden decrease in blood pressure and heart rate and therefore to a decrease in blood flow to the brain, causing syncope, and sudden fainting.

    The vagus nerve now leads us to introduce the risks related to blood compression and nerve compression.

    Blood compression is the less disabling of the two just mentioned unless the tied person suffers from pressure problems, thrombosis, phlebitis, or other problems related to the cardiovascular system, in which case the margin of risk of incurring more serious injuries increases. In this regard, we remind you of the importance of communicating to the rigger every single physical and mental problem before each session. Blood compression consists of a reduction in blood flow in the vessels, so generally, it is enough to remove the blockage and in a fairly short time the situation returns to normal. The reduction in flow can be caused by the ropes, for example by a too-tight cuff, or it can be postural, for example, due to a bent leg tie (futomomo) where the vessels tend to self-compress. The symptoms of blood compression consist of a change in skin color (which can vary from white, red, blue, or purplish depending on the subject), a more or less accentuated tingling sensation depending on the degree of compression, but also discomfort or pain of the affected limb. Other side effects of blood compression are coldness of the extremities and, as already mentioned, petechiae and hematomas.

    Nerve compression needs a more in-depth approach because it can have quite disabling effects. Let’s start by saying that nerve compression is caused by a crushing, with consequent damage, of the myelin. Myelin is a protein-lipid sheath that covers the nerves and which allows the correct conduction of nerve impulses, amplifying their transmission speed. It also has an important insulating function because in the absence of myelin the neurons, being excitable, would respond to the many surrounding signals, just as an electric wire without an insulating cover would disperse the current without carrying it to its destination. An equally important function of myelin is that of mechanical protection and nutritional sustenance.
    When myelin is damaged, the passage of impulses is more or less compromised depending on the damage and, depending on the nerve involved, it can cause reduced sensitivity and asthenia (reduction or loss of muscle capacity). The damage, since it involves precisely the system that transmits the information, can occur without pain or other symptoms. So it’s not really the case to say “no news, good news”!

    In a bondage session, nerve compression is due to the ropes which insist for too long and/or too strongly on one or more nerves causing damage to the myelin sheath. It, therefore, becomes important to know where these nerves are in order to try to avoid them. The problem is that the nervous system is extremely ramified, it reaches practically any point of our body and it is impossible to map it exactly except through specialist tests.
    This obviously does not mean that we do not have any idea of where the main nerves of the body are located, on the contrary, there are also quite detailed diagrams, unfortunately we cannot rely exclusively on those to be safe, because the anatomy of the body it varies from person to person and even a shift of a few millimeters can make the difference between a good rope session and an accident.

    As I said, there are many nerves with very different paths, but there are some that are more likely to be involved during a rope session.
    The vagus nerve that I mentioned earlier starts from the medulla oblongata and travels, through the jugular foramen, downwards in the thoracic cavity to the abdomen. In particular, it innervates both the intestine and the stomach, thus giving symptoms of nausea and vomiting if solicited. As long as it remains in the chest cavity it is quite protected but in the abdomen and sides of the neck, it is not that difficult to encounter.
    The femoral or crural nerve is one of the major nerves in the leg. It arises from the lumbar vertebrae, crosses the pelvis at the height of the psoas and then descends frontally into the leg. The muscles of the legs are quite important and this guarantees the nerve some protection. However, at the height of the head of the femur/groin it can be more exposed and here, in the case of a futomomo, hipharness or other “stray” ropes, it is possible to intercept it. Getting to know him can lead to weakness of the flexor muscles of the hip and leg and loss of skin sensitivity.
    The group of nerves that, both by exposure and by the frequency with which they are affected in ties, has a fairly high probability of being involved in accidents is the radial-median-ulnar group affecting the arms. This group of nerves arises from the cervical vertebrae and, passing through the shoulder with a fairly common route, exits the armpit and branches along the arm to the fingers.

    The path of the median nerve crosses the arm longitudinally remaining approximately in the center.
    The ulnar nerve runs fairly parallel to the median but, as the name suggests, more towards the ulna. Both are more exposed on the inner side of the arm.
    The radial nerve, on the other hand, has a more particular path, it comes out of the armpit like the other two but then takes a spiral path that goes behind the humerus and, almost at the elbow, moves to the outside of the arm starting to run parallel to the radius up to the hand.



    This group of nerves is responsible for the muscle innervation of the arm and hand, as well as for sensation.

    The median nerve is responsible for the sensation of approximately 2/3 of the hand, predominantly the palm and the tips of the index, middle and ring fingers. The ulnar instead of the lower part of the hand, ring and little fingers, palm and back. The radial has the upper back and thumb.


    The points where these nerves are most exposed, therefore potentially riskier, are:
    Wrists: here all three nerves are quite superficial and potentially exposed.
    inside of the forearm
    – armpit and brachial plexus, mainly with the use of a chest harness with free arms or in the case of very tight Tasuki lines (ropes that pass between the neck and head of the humerus)
    back of the arm, between the triceps and the elbow, mainly in the gote/takatekote position.

    As already mentioned several times before, these points can vary and depend on the anatomy of each subject as well as on age and body conditioning.

    Compared to blood comprehension, the recovery time after a nerve compression can be very long, in the order of weeks/months. Considering that the more time you spend in compression, the worsening of the problem increases exponentially, it becomes essential to be able to understand as soon as possible if you are actually in this condition.

    But how is it possible to understand this?

  3. How to recognize a nerve compression.

    As mentioned, nerve compression involves precisely the system that carries the informations, so it could also occur in the absence of particular pains or other symptoms. However, this does not mean that we must remain at the mercy of events. We have seen that nerves activate sensitivity and muscle stimuli, so in the event of compression one or both of these functions can be compromised. The checks we can do are precisely aimed at these factors. We need to check that we still have feel and movement and we need to do this periodically throughout the session.

    In the case of the femoral nerve, it gets a bit complicated, especially if the leg is locked in a futomomo. The foot, while remaining free to move, can be moved and rubbed by controlling its sensitivity. You can also test hip mobility by trying to bring your knee to your chest. If these checks should give a negative result, it is advisable to immediately communicate it to your rigger, who will act accordingly.

    The hand checks are a little easier to do. Unlike the legs, which are more often tied separately from each other, the arms tend to be incorporated into the same binding, this allows us to compare the arms to each other to better understand if there is compression in place. The following checks should therefore be done at the same time, comparing the intensities of the right hand with the left hand.
    hitchhiking: with clenched fist raise the thumb. If you are unable to do this movement the radial nerve may be compressed.
    – back and forth movement of the wrist, as if you were accelerating with the moped. This is another movement coordinated by the radial that if you can’t do it is an indication of compression.
    make a fist (open and close the hand). Depending on the part of the hand that you are unable to move or the movement that you are unable to make, one or more nerves of the group may be compromised (see previous figure). Attention: this movement must be done only once at each check-up because if it is repeated several times it could, if it is not already in place, cause blood compression, thus aggravating your condition.
    press the fingertips against the thumb. This check, in addition to verifying if you still have sensitivity on your fingertips, also measures its strength. Always referring to the previous figure, in case of a negative outcome you will be able to understand which nerves are involved in the compression.
    Always referring to the previous figure, even feeling a localized tingling in one of the three identified regions is a symptom of nerve compression.
    If, on the other hand, you feel a tingling extending to the whole hand, it is in all probability a blood compression.

  4. What to do in case of nerve compression.

    Unfortunately, accidents also happen to the best, so it is not the accident itself that qualifies you as a rigger, but what you do afterward, that qualifies both as a rigger and as a person.

    The first thing to do if you realize that you have a nerve compression in progress is to warn the rigger, because we have seen that the more time you spend in the problem, the longer time you will need to recover.
    Secondly, further compressions must be avoided, even if the damage is minor, therefore avoid massages and obviously avoid doing other sessions at least until complete recovery. Rest is recommended.
    Avoid taking random medicines. In cases of nerve compression, anti-inflammatories and vitamin B supplements are generally recommended to help restore myelin but, as already stated at the beginning, I am not a doctor and consequently I suggest you run to your or to the emergency room and explain in detail the situation without embarrassment.
    In the first few minutes after the accident it could be useful to apply ice locally even if, for the action of cold to be effective, it should be applied to the exact point where the compression took place, and we have seen that it is not so easy to establish.
    Give each other support. The rigger will have to help the person who has suffered the accident as much as possible, perhaps accompanying him/her to the doctor and/or to carry out the necessary checks, supporting him/her psychologically and in the daily things he/she is unable to do due to temporary disability, then ensuring the course until to complete recovery.
    on the other hand, the injured person would be good to give psychological support to the rigger, to prevent the person from blaming him/herself too much and going to block by stopping tying for fear of hurting someone again.
    Having patience is a key factor during the healing process because nerves take a long time to get back to 100%. It is also not like healing from a cut that once the stitches or scabs are removed the wound is healed. Better to be patient and wait maybe an extra week to be sure you’re fully healed.

    Last but not least, since a certain correlation has been noted between the accumulation of nerve compressions, even slight ones, and the increased likelihood of having another compression of the same nerve, after the first accident you pay much more attention to the various symptoms I illustrated earlier.

18/06/2023