My observations as a rope bottom: By shevah~ © April, 2006
www.ds-arts.com/shevah I wanted to further address this issue (or maybe this is a rant) about nerve compression. The usual causes are direct trauma, prolonged pressure on the nerve, and compression of the nerve. Prolonged pressure may be complicated by ischemia (lack of oxygen from decreased blood flow) in the area. Entrapment involves pressure on the nerve where it passes through a narrow structure. The damage includes destruction of the myelin sheath of the nerve or destruction of part of the nerve cell (the axon). This damage slows or prevents passage of impulses through the nerve. The "club" hand or 'wrist drop' happens when the radial (n. radialis) or brachial nerve gets compressed. This can be caused for numerous reasons. Many years ago this also happened to one of my family members by a well known rope top who was extremely experienced with rope bondage but had little experience with rope suspension. She was up less than 10 minutes and it took her months to regain the use of her fingers again and 2 years for rope to ever touch her again. It is unknown if this was caused by compression from inside the arm by the cinch used or from the outer compression wrappings that may have been lying in that dangerous junction between the deltoid muscle and bicep/tricep muscle group, both of which uses the Radial/brachial nerve. BTW, there were no ropes on her forearms and her arms were not in a traditional 'box' position, but loosely relaxed behind her back, wrists tied together in this face down suspension. I am all about sharing information and those who know me will attest to this, but I find it amazing that we spend so much time talking about rope strengths, which knots to use, natural vs synthetic, oils for conditioning, spotters, to wash or not wash rope ... and still 'we' are unaware of the body's anatomy. Because us 'rope bunnies' need to be recyclable, all of your lengthy prep work will last only 10 minutes of play time if one does not educate themselves about these dangerous areas of the upper and lower arm (inner and outer) and the consequences of nerve compression accidents. We have a lot of new folks who have joined our ARA group lately, so i am going to stick my neck out, step up on my soapbox, and share a few things. These are just my opinions and YMMV. If you look at the radial nerve picture provided by Gray's Anatomy, you can see that it is located between two muscles bands that move independently. The trouble that occurs is when the rope wrapped around this area "traps" the nerve between the two muscle bands and against the bone near the surface of the skin, which compresses (strangles) the nerve. The placement of the rope is essential in understanding this problem and it is critical to know where NOT to wrap the bindings of the rope to prevent this from happening. Areas to avoid include the upper arm between the Deltoid and the Tricep muscle groups and just above the elbow where the radial nerve turns and wraps around the arm. Although there are various opinions on exactly how radial nerve damage actually occurs, I can say with certainty that the amount of time, weight, position, or body mass have little to do with the outcome. I have witnessed radial nerve trauma causing a club hand in less than 5 minutes while maneuvering into a partial suspension. One adjustment that can be made to prevent damage is after the rope is wrapped around the limb, take your fingers and run them along the inside of the rope that is lying against the skin to allow the muscles the freedom to realign to its proper placement and protect the nerve. Even though each bottom's anatomy will be a bit different and muscles will shift differently under pressure, it is important to know the basics so that both the Top and the bottom are aware of the risks involved. As many others have pointed out, even with this knowledge, shit happens and the affects can be cumulative. Again, my mantra is: RACK - Risk Aware Consensual Kink. One of the main 'mistakes' i see when watching rope Tops tying a chest harness or a takatekote Takate-Kote is that after the ropes are around the arms, they cinch both the upper and lower ropes together, which causes the ropes to slide into one another (from the upper Deltoid muscle and from the lower Tricep muscle) and gathers in that dangerous tissue junction area. That is where the bottom is most vulnerable to nerve compression because there is not enough muscle between the connective tissues of the skin and bone. (I know this concept is disputed). Additionally, this adds to the total bulk of the cinch under the arms. Depending on the type of bondage play, this can become dangerous. Furthermore, when witnessing the wrists tied together, many mistakes are made that are easily overlooked. The inner wrists should be facing one another - the rope should not be exposed to the inner wrist area under pressure. A military parade rest position should be avoided if possible. If you desire space between the wrists or if the bottom cannot connect their wrists or hands together, then you can tie a reverse bar wrap starting with a 'bolla-bolla'. Do NOT use a larks head over the wrists if there is going to be pulled tension placed on those limbs. It WILL tighten up on itself without the Top's awareness. Allow for enough slack so that the bulk of the knot can lie in the hands to grasp onto and not lie tightly against the inner wrists. If you are tying the wrists together, be careful not to tie too tightly! Again, the hands are usually the first to go numb. Each bottom will have a different preference as to this tightness. YMMV. It is advisable to use a quick release knot so that the hands can be untied easily with one pull without the entire harness needing to be untied. If you see your bottom continue to rotate/turn their wrists in the binds while being tied, they are giving you a clue. Either they are trying to loosen up the ropes a bit before you tighten down, or they are already uncomfortable with its tightness. Watch your bottom's body language for signs!
Cinching: Why is cinching done? Cinching (tying separate bands of rope together) is done with rope to stop the movement of that rope either upwards or downwards (vertical), or from side to side (horizontal). Unless you are an "eel" and squirm around a lot, IMHO, if you are being suspended in a horizontal position, there is no need to cinch the rope under the arms. When the upper Deltoid rope is cinched, it can have a tendency of shifting upwards towards the armpit (axilla) and can cause compression of the nerve creating "crutch palsy". When the lower Tricep rope is cinched, it can cause the medial area of the nerve or the Ulnar nerve to be compressed causing various nerve problems. Outside of suspensions, I have found two problematic commonalities with rope bottoms. One is that the lower rope bands around the triceps are tied too tight and compresses the tissue to the point that it becomes uncomfortable. The tricep is smaller and less dense than the deltoid, so this makes sense. The other is that cinching causes many of the problems of compression. It is usually done TOO tightly! I will say that again ... The cinch is tied too tight! I can usually count to about 90 seconds before i see the rope bottom start rubbing their thumb and index finger together - a sign that tingling and numbness is occurring!!! Watch for this in your bottoms because even 'they' are not aware that they are doing this tactile rubbing. So, why cinch the top arm wraps in the first place you may ask?
And why are the lower arm wraps around the triceps cinched you ask?
Ah, now you ask, Do you need to go around the arms to suspend somebody?
Of course a side-ways suspension would be problematic in itself.
There are usually two (2) common reasons that rope bottoms ask to come down from a face-down chest/takate-kote harness suspension.
There are 100+ different ways to tie a chest harness and more then 100+ opinions on how to do it "better". Knowledge = Power. The more we know, the more we have the ability to utilize that knowledge and continue to be powerful. Along with defining anatomy (found at the end), i also wanted to address some of the Signs & Tests one can do to determine any nerve dysfunction.
Signs & Tests I get asked many times, "How do you know when damage is occurring?" That is a hard question to answer. One of the obvious answers is if it really hurts - a bad, burning, searing, jolting pain, then you know there is a major problem and you need to come out of the ropes, now. But most of the damage i have either witnessed or heard about has "snuck" up on the bottom without much warning. It was only after they came down from the suspension or came out of the ropes did they notice a problem. In some cases, bondage can result in compression of the femoral nerve in the upper leg and groin area. Symptoms may include numbness of the inside of the knees or front of the thighs. In my own experience i have had the top of my thigh go numb without any notice. There was no discomfort, no tingling, no pain, no pinching, and no inability to move my limb/toes/foot, no nothing. I noticed it after the ropes were off of me and i was pulling my pants up and it just felt weird going over my thigh. The top part of my thigh, about 5" from my hip to about 5" above my knee was numb to the touch. It stayed that way for about 4 weeks and then just disappeared as oddly as it came. Although this had nothing to do with the radial nerve, it did encompass nerve compression, so it fits this subject. CSM Test - The CSM (Circulation, Sensation, Movement) test can be used to check for the occurrence of possible bondage related injuries to the extremities. It should be noted that the test does not provide any absolute guarantee against such an occurrence. Even in the absence of warning signs, injuries such as nerve compression may still occur. Circulation is often checked by monitoring for changes in color and temperature of the skin. Another method is to perform a Capillary refill test. Capillary Refill should be (in a healthy person) no longer than 3 seconds and can be tested properly by compressing the finger or toe nails till it turns white and then releasing - watching for the redness to re-appear. Sensation can be checked by tickling or pinching. Someone once suggested using a feather to detect any nerve compression issues and i have to agree with that theory. Because i had full usage of my leg/foot/toes, and there was no tingling or loss of strength, the only way i really knew i had numbness was a very light stroke over my skin, usually i just used the tip of my fingernail gently gliding over one thigh and comparing it to the other thigh. So using a feather would have been a good idea in my case to detect the small amount of numbness. Movement checks. Other neuromuscular suggestions that i know help towards determining radial nerve compression dysfunctions involve movement checks. These exercises will examine muscle strength, sensory touch, and nerve coordination. Your bottom's handgrip should be the same strength as before you began the rope bondage - one of the predeterminations you should assess before a scene begins. Finger dexterity is also essential to check throughout the duration of the scene. The bottom should be able to touch, with pressure, each finger to the thumb (much like counting on your fingers). Check the muscles for limb extension weakness of the fingers, wrist, elbow, or (if the arm is not bound) a minor decrease ability to rotate the arm outward (supination). Wrist drop or finger drop may be present, or there may be atrophy (muscle loss) of some muscles of the forearm. Be aware of differences in the two hands - if one is in a clinched fist position and the other relaxed, limp or not moving. Also, notice any thumb to finger(s) rubbing together, which is the body's way to tell you there is numbness or tingling on the skin surface. Be aware of your bottom's body language and take a moment and check for these simple signs of a healthy body.
Play Safe! shevah~
Delight in the journey, not the destination ~~~
Definitions by Gray's Anatomy: Bicep Brachii Muscles The bicep is a muscle located on the upper arm. The term biceps brachii is a Latin phrase meaning "two heads of the arm", in reference to the fact that the muscle consists of two bundles with a common insertion point near the elbow. The biceps has several functions, the most important simply being to flex the elbow and to rotate the forearm. It is arguably the best known muscle, as it lies fairly superficially, and is often well-defined even in non-athletes. Deltoid Muscles The deltoid is the triangular muscle of the shoulder that forms the rounded flesh of the outer part of the upper arm. It passes up and over the shoulder joint. The wide end of the triangle is attached to the shoulder blade (scapula) and the collarbone (clavicle). The apex of the triangle is attached to the upper arm bone (humerus), about halfway down its length. Its strongest point is the central section, which raises the arm sideways. The front and back parts of the muscle twist the arm. The ligaments, which connect the muscles to the bone endings, are called "deltoid ligaments." Deltoid comes from the Greek word "deltoeides," meaning shaped like a (river) delta. It uses the Axillary nerve, but splits off to the radial nerve.
Triceps Brachii Muscles
The triceps brachii has three heads (connective immovable muscle) and is the only muscle on the back of the upper arm. It connects the humerus (upper arm bone) and the scapula (shoulder blade) to the ulna (longest of the forearm bones) and is the primary extensor of the elbow. The three heads are the "lateral," the "medial," and the "long head." It uses the radial nerve.
Ulnar Nerve - Interior The ulnar nerve is one of three major nerves that provide sensation and motor function to the hand. It runs down the inside of your forearm to the heel of your hand. It then branches out across the palm and into the little and ring fingers. The ulnar nerve also passes through a narrow tunnel at the elbow, also referred to as the 'funny bone'. Excessive pressure on this nerve can result in a loss of feeling and/or muscle weakness in the hand. You may or may not have pain in your hand, but you will probably experience weakness and increasing numbness, particularly on the little finger side of the hand. You may experience sensory or motor changes or both, depending on the location of the pressure point. Symptoms develop gradually and can lead to difficulties in opening jars, holding objects, or coordinating your fingers while typing or playing a musical instrument.
Radial Nerves Also known as the musculospiral nerve. The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. It also provides extension to the wrist, and helps in movement and sensation of the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the nerve, and compression or entrapment of the nerve from nearby body structures. The radial nerve may be injured at the Axilla (underarm) by direct pressure, such as "crutch palsy," caused by improper use of crutches, or pressure caused by hanging the arm over the back of a chair. Axilla (or armpit) provides a passageway for the large, important arteries, nerves, veins and lymphatics, which insure that the upper limb functions properly.
Medial Nerves - Anterior Medial nerve is formed in the axilla by a branch that supplies impulses to the muscles of the forearms, and to the muscles and skin of the hands. The median nerve can be injured at the elbow or wrist.
ILLUSTRATIONS Nerves - Left Upper Extremity
Suprascapular Axillary Radial Nerves
Femoral Nerve
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