This page is for guidance only and is neither exhausitve, nor is it written by medically qualified personnel. Additions and corrections from the medical profession or any relevant experts are very welcome.
Bondage is probably the most risky area of BDSM, but also the most popular, especially with newcomers. Accidents do happen. Many of the most experienced practitioners have had incidents. Shibari, in its original form, was designed not only to restrain, but to torture and kill. Do not underestimate the effects of even relatively simple bondage. Have fun but go slowly and take no chances.
Since suspension massively increases the risks, it should not be attempted without the personal guidance of an experienced practitioner.
Do not rely on bondage pictures you see on the net as a guide to what is safe bondage practice. They are likely to be of experienced bondage models in positions only held for the few seconds it takes to shoot the picture and are staged by an entire crew. Much of it is definitely not safe. Also, with the use of photo-editing software, the impossible can easily be faked.
Always keep a safe tool capable of quickly cutting your strongest rope to hand, e.g. EMT shears or bandage scissors. If you use chains, you'll need bolt cutters. If you need them, you are likely to need them quickly. Use of panic snaps for all load bearing lines is helpful, as it can be very hard indeed to get a person out of suspension after they have become a dead weight after becoming unconscious. In many respects it is better to suffer a fall than to hang from a suspension line after unconsciousness. However, panic snaps do not let down gently, but instead release abruptly which may allow recoil of suspension lines, and loss of support from suspension lines. Like all suspension, use of panic snaps should be very carefully planned, with an eye to possible failure sequences and maintain safety even so.
Monitor the bound person very carefully. Communication is essential. Check to see if there is any unwelcome discomfort, whether a knot or rope could be adjusted for better effect. A knot digging in or a rope chafing can adversely affect the whole experience. Eye contact (if no gag or hood is used) will tell you volumes. Observe breathing and skin temperature.
Make sure you have unambiguous safewords. A safe-word can be any pre-arranged signal or word to end or change the pace of the session. This is vital when No or other pleas to stop could be just part of the game. For example, colours are popular choices, e.g. red = stop immediately, orange = I'm approaching my limits and green = go on. Safe-words are important and must always be obeyed instantly. Don't even joke about ignoring them. If you have any doubt that the person tying you will not respect them, walk away. An experienced dominant should be aware enough to pre-empt their use and any good one will take their use seriously.
The 'double squeeze' technique is a sensible safeguard, i.e. the binder gives two squeezes of the hand to the bound person; if all is OK, they return them. Failure to respond should set the alarm bells ringing.
It is recommended that you are familiar with basic First Aid and resuscitation.
Falling and fainting
The most obvious hazard to both falling and fainting are impact injuries through striking the floor or other objects.
In order to minimise the risk of fainting, you should make sure that the bound person has eaten fairly recently and does not become dehydrated. Energy drinks, water and snacks are good to have handy. Alcohol and drugs (legal or otherwise) should be avoided as they increase the likelihood of accidents.
However, bondage carries additional risks. Be very careful what you tie to fixed or heavy objects. For example, the consequences of tying piercings in this way and a fall could be very unpleasant - what could happen to genitals doesn't even bear thinking about.
Fainting or a fall can easily result in dislocation or strangulation, as ropes can be pulled out of position or result in unexpected stresses.
Tight bondage and hands above the head positions tend to figure in many fainting incidents. Corsets appear to exacerbate the problem. However, suspension is the most likely type of bondage to cause fainting as it produces extra stresses and is likely to make breathing difficult. Recently, after suspension, I had one sub faint as she was being removed from the bondage and another come close to it. Fortunately, in both cases, the warning signs were heeded and they were both brought to the ground safely. Make very sure you know what you are doing before trying suspension.
At the risk of stating the obvious, make sure that any fixing or suspension points are very secure. For overhead points, you can be reasonably sure that floor joists are strong enough. However, your fixings should be of suitable specification and properly mounted. Miss a joist and you will almost certainly bring the ceiling down. Guaranteed to kill your passion, if not you or the other person. Wall mounted points will either need to be screwed into brickwork with Rawplugs or directly into the battens in a cavity wall. If in doubt, get qualified help.
A further point to consider is what will happen if the dominant faints for any reason (such as epilepsy, accident or overexcitement). There should always be a margin of safe time when the person being bound can remain as they are while the one binding recovers.
Fire and emergency
If the worst happened, how quickly could you get you and your playmate out of the house? It is all too easy for a candle or cigarette to get forgotten in the heat of the moment and start a fire. Could you find your safety scissors in time?
Leaving a bound person unattended is just plain irresponsible. Any of the problems in this section could occur, and with no means of escape, the consequences could be damaging or lethal.
Common sense should apply. In my opinion, those with conditions such as heart, breathing problems, blackouts or fits should avoid bondage. Bondage can be very stressful. One should also be aware of injuries or anything, which may be exacerbated.
Rope burn and splinters
Test ropes on yourself. Pull the rope across your own skin (a soft and sensitive area) and note how fast it has to travel before it becomes uncomfortable. Synthetic rope heats up at much slower speeds than natural fibre.
Some natural fibres can be very harsh and prickly, e.g. sisal. Washing or boiling the ropes solves this problem. Fabric conditioners or an oil, such as Mink oil, can be used to soften the ropes further. Stray fibres can be carefully burnt off with a candle.
Cheap polypropylene ropes often seen in builders merchants and DIY stores are unsuitable as they can shed minute splinters, especially when they become old.
Choking, strangulation and breathing difficulties
To minimise the risk of strangulation, never place a rope over the front of the neck or around the neck. Nooses are definitely out. The only safe configuration is halter neck style, so any pressure is on the back of the neck. You should also be aware of ropes, which may slip and end up around the neck. The risks are multiplied with suspension or if the bound person falls or faints.
A bound person cannot remove a gag. It is your responsibility, so you need to be observant and not leave them unattended. Never use anything that could be swallowed, become lodged in the throat or obstruct the airways.
Breathing difficulties can also be caused by constriction, e.g. of the rib cage. Don't tie too tight. Remember that as you add wraps of rope or cinch the bindings, the tightness will increase.
Certain positions can make breathing difficult. The degree of stress to which the bound person is subjected can also increase breathing rates. Never underestimate the effect of being bound in a fixed position can have over time. The muscles, if over-stressed can become exhausted, and the result is positional asphyxia. This is very unlikely to happen to somebody who is being monitored but it is a serious risk if you leave somebody alone for a long time or fail in a self-bondage escape.
In particular, suspension needs to be treated with extreme care as it can turn normally comfortable ties into crushing constriction. Suspension was used as a method of torture in the original forms of Shibari. It can kill.
Most serious incidents are a result of self-bondage or auto-erotic asphyxiation gone wrong. For example, the fool-proof escape system can become impossible with numb hands or cramp. The old adage "If it can go wrong, it will" is worth considering.
At best, lack of circulation causes 'Pins and needles' and numbness. At worst, body parts are damaged or even die without a blood supply.
Restricting circulation should be avoided by keeping a little slack in the ropes. The 'one finger rule' is that you should be able to slip a finger under the bondage. Keep an eye out for ropes tightening during play or as you build up the bondage. Insist that they should not to try to be a hero and inform you immediately of any tingling, unpleasant pain or loss of sensation.
Avoid placing knots on blood vessels, e.g. on inside of wrists. Also, tie above, not on joints. The thicker the rope and the more turns, the lower the risk. Anything less that 6mm (1/4") should be avoided for general use.
Hands usually suffer first. So as not to end your scene prematurely and for safety, it is a very good idea to do your bondage so that the hands can be easily released without having to untie everything else.
Temperature is a good indicator. Note how warm the person's hands and feet are at the start of the scene. If they become noticeably colder, it is possible that circulation has been restricted. Another test is to squeeze a finger or toe and see how quickly the colour returns to the nail. The slower the return, the worse the circulation.
Nerve damage can be painless and thus occur without any warning. It can be permanent. The first method of minimising damage is to stick to the 'one finger rule'. The second is to familiarise yourself with the major nerves and where they are at risk from compression. A study relating to upper body nerve injury avoidance is here damage part 1a.pdf. It is fully illustrated with diagrams and, more importantly, photos showing the danger points.
It is a very serious risk with suspension bondage as this increases all the loads and stresses. The most common problem seems to be radial nerve damage, often due to pressure on the outer side of the upper arm, Problems can arise when a 'box tie' or chest-harness which also surrounds the arms , as opposed to only the chest, is used as a suspension point. Make sure you know where this nerve runs. See diagram. The point in the middle of the upper arm is very vulnerable, roughly where the nerve disappears behind the bone in the diagram.
Obviously, physical force should be used with care. Moving a bound person around can put unexpected strains on limbs. Falling creates, probably, the biggest hazard; not only from contact with the ground, but also where limbs are attached to a static object. Hoists, pulleys etc. should be used with care, the extra mechanical 'muscle' they provide could easily result in dislocations.
Always be aware of the risk of the person falling. Having the arms tied will hamper their balance. Loose or surplus rope can cause a tripping hazard. It is not a bad idea to attach a safety rope to part of the body harness to a secure overhead point, especially if the bondage involves tying the legs or ankles.
Where not to tie
I make no apology for reiterating that you should never place a rope across the throat or in a way that it could obstruct circulation or breathing. Passing the rope over the back of the neck 'halter-neck style' is the only safe method and even then it should not be so tight as to press on the throat.
In general, bindings should not be placed on joints, except the hips. This can lead to loss of circulation or nerve damage. Take care to place arm or leg bindings above the bony area of the joint. Leave plenty of slack as cinching will often tighten the binding more than you expect. Use the 'one finger' rule.
Vulnerable areas include:
- Carotid arteries
- Cervical vertebrae
- Brachial artery
- Brachial vein
- Inner bicep
- Brachial artery
- Medial cutaneous nerve
- Cephic vein
- Basilic vein
- Medial cutaneous nerves
- Lateral and posterior cutaneous nerve of forearm
- Inner thighs
- Femoral artery
- Femoral vein
- Back of knee
- Nerves and arteries
- Advice: Bondage
- Bondage positions and techniques
- Safe, sane, and consensual
- Risk-aware consensual kink
- Safe sex
- Unsafe sexual practices
- Breath control: Safety