Home for Wayward Sluts: Rope Nerve Damage http://kinkunveiled.blogspot.ca/?zx=8dcd321b700cd6d8

Wednesday, 27 November 2013

Rope Nerve Damage

Ok, I've been promising some rope safety info for a bit so its time to man up and get it done.  Let's talk about nerve damage and how nerve damage can be caused, avoided and healed.  I'll talk about what nerves are, what they do and how they can be damaged.  Then I'll talk about how to avoid damage and what to do if some damage has occurred (aka First Aid and Treatment). 

As said before, Shibari and rope bondage is dangerous and your job as a Dom is to know your stuff! That includes anatomy, nerves, first aid and proper techniques. 

Disclaimer: I'm not a Doctor and have no fucking clue what I am talking about. You will always be better off to ignore everything I say as 'crap you read somewhere on the internet' and ask a real doctor for advice. Hell, I don't even proof read my blog posts. Ever. :-p

What are Nerves?
Nerves are basically electric wires that run through the body.  Nerves are like bundles of wires that transmit electrical signals from one place in the body to another. Nerves are mostly located fairly need in the body within soft cushy muscle to keep them safe and well padded. Most importantly, nerves are made up of groups of living cells. They all work together to pass the signal from one cell to the next. I could talk about the structures of nerves and how they know when to fire...but that's all kinda irrelevant. The important thing to know is they are made of living cells that are like little bugs that can be squished or suffocated. 

What do Nerves Do?
Nerves transmit electrical signals along this wire pathway that transmits signals and sensations such as heat, cold, pain, pressure, vibration and where the body part is in space.  Nerves also transmit signals from the brain back to the body part -- mostly telling muscles to move or in my case right now...which keys to press.

What is Nerve Damage?
Nerve damage occurs when some or all of those nerve sells are killed because you've squished them,
crushed them, starved them of oxygen, or stretched them too far (often while compressing too).  Because killing cells is at the root of nerve damage, the amount and severity of the trauma has a direct impact on the amount of damage done.   If you utterly crush a nerve and starve it of blood for a long time....it kills ALL the nerves cells over a significant length...meaning the nerve doesn't have any 'core' cells to regrow and repair...and the damage is permanent.  This can be done by tying a rope really tight and constricting and leaving it on for too long. Note: Too long varies tremendously depending on exactly where you are tying, how it compresses the nerve, and the physical condition of the person being tied.  Sometimes only a few cells die and the nerve returns to normal after an hour or so...it all depends on how many nerves survive.  Nerve damage can also be cause by sudden impact on the nerve from things like falling on the nerve, falling and having a rope 'catch you' and dig into the nerve, or even from some impact play (though this is much more rare as most nerves are really deep and you should be hitting muscles. 

What are signs of Nerve Damage?
Nerves come in bundles and some are specifically to transmit sensations of cold or heat while others do pain, vibration, physical location or sense pressure. This means that ANY of these sensations can be indicators of nerve damage. I say again, IT'S NOT JUST PAIN! 

  • tingling
  • feeling too cold
  • feeling 'overly compressed'
  • "pins and needles"
  • electric shock sensations
  • pain
All of the above can be signs that nerve damage is occurring.
Stretched backwards with the upper arm ropes on the radial nerve?
How about her wrists?
And why is she dressed like she should be bringing me
a plate of mashed potatoes?
Think of your leg or hands falling asleep. It doesn't necessarily hurt...but it may when blood flows back to the nerves as they start to recover.  And just like you leg falling asleep...often it gets better in a few minutes all on its own.

Note: DAMNIT! Why did my blog change format here! :'( Where is the Greatest Risk?
The greatest risk of nerve damage is places where the nerves run close to the surface and/or near a bone that it can be pressed against to squish it like a bug. The radial nerve on the wrist is an excellent example of this...wrists are small, boney and the nerve both runs close to the surface and near the bone.  This is quadrupley important not to damage because hands are really useful.

Risk is increased by increasing time, increasing levels of rope constriction, having greater amounts of force or greater amounts of stretching.  Also, by tying areas where nerves are close to the surface significantly increases risk-- especially where nerves are close to the surface and next to bones...so tying them presses them up against the bones.

I'll try to come up with a nerve map and places to avoid tying but...not just yet ;)

What to Do if You Suspect Damage is Occurring
1) Shift the rope position (move it up or down on the limb)
But the problem is, the rope nearest the sensation may not be the cause.
2) Untie and tie her in a different position
3) In extreme cases, cut the ropes -- but be careful! Don't cut just any rope so she falls to the floor.  Cut the suspected causing rope if it's safe or cut a supporting leg free so she can take some of her weight and not splat on the floor.


First Aid (right after)
If your little rope bunny gets hurt --is take a deep breath and center yourself. She need you calm and is depending on you.  More than ever, this is the time to be strong.  Now as you're reassuring her:

1) Loosen the constriction as fast as possible.  If it's looking serious: don't hesitate-- cut the fucking ropes.  (Remember how this is time based? Well a few seconds can make all the difference.)   Note: Blood rushing back in may cause her more pain -- and not the good kind. Remember that blood rushing back in is the best thing for her...but maybe slow down a bit to reassure her so she can take it.

2) After the rope is off, straighten the limbs.  This keeps the nerves in the best position for bloodflow.  Don't elevate, compress, or ice the limbs...that's to reduce blood flow for muscle damage. Nerves need blood.  Some mild shaking can help if there's no pain (think of your hands that have fallen asleep and how shaking them helps...it's exactly like that. Your hands are asleep because the nerve was compressed.)

3) Hope she recovers quickly.  Just like a leg that's fallen asleep...it can get better all on it's own real fast. Most times it resolves fairly quickly. Other times it takes a couple of hours...or a day...or longer. So hope you're lucky.

4) Stop rope play for a bit.  Remember that nerve damage is cumulative. So if you immediately tie up the limb again...it's gonna start from where you left off.  Hell, I've heard people say they've used the same ties every day without incident for a month and then had trouble with it every day since. That's because small amounts of damage were done each day and after a month they were just adding more and more damage to it. But after not using that tie for a month...everything was fine again.

If You're Not Lucky (what to do next)
If you're not lucky, then you've removed the constricting rope, safely got her on the ground and now...the pain or loss of sensation/motor control or feeling of cold are still lasting. What now?

1) Make sure the nerve is not compressed in any way whatsoever. That also means not stretched at all. Keep it in a comfortable position.

2) Keep the limb below heart level so blood flows easily there.

3) Take a couple Aspirins. Aspirin thins the blood and helps with circulation as well as the pain she may be experiencing. Aspirin can also reduce swelling around the nerve and alleviate swelling compression.

4) Wiggle your fingers or toes (wherever the problem is) to encourage blood flow -- but only if it's not damaged and this could cause swelling. Use your judgement.

NOTES: If the area around the nerve is swelling and bruised too...there could be an issue with the swelling adding to the compression of the nerve...but in most cases this isn't happening. But if that seems to be an issue, don't wiggle. Rest the affected area. Also you can apply ice as in most cases the nerve is deep in the muscles and won't be negatively affected by the coldness on the first 1-2cm of tissue.  That said, if the problem is at the boney part of the wrist, ankle or around the elbow then ice and compression can aggravate the injury.  Disclaimer: I don't know this for sure but nerve damage seems to trump muscle damage so I'd go with what best for the nerve over best for the muscle.


Long Term Care: Heat
If the limb is severely fucked up and not returning to normal after 2-3 days...I recommend you see a
umm...not that kind of heat
Doctor! Earlier is better as Doctors pretty much all know medical stuff than I do.  If full sensation has not returned to normal after 7 days (7 if there was some other injury to the area, as little time as 48 hours if there was no damage to the area)...it's time to apply heat:

1)  Wait a week for the trauma and swelling to go down and normal blood-flow to resume.
2)  Apply a heat to the affected area for 15 minutes:

  • Dry heat is best (hot towels make you perspire and think you are heating more than you are...and since we want to heat deep down near the nerve, wet towels are not so great for heating nerves.
  • IR-A infared heaters are ideal
  • electric heating pads and heat packs also work well. 
  • heat the affected area and leave the heat on for 15-20 minutes 
  • check that the skin isn't going bright red and is too hot (especially important if heat sensing nerves have been affected)
  • reapply every 2-3 hours during normal waking hours (each application stimulates nerve healing and bloodflow to the region so more is better but if you miss some it's not an issue.)
  • Heat until you see an improvement. This could take 2-3 days or 2-3 months.
  • Don't keep tying or compressing that area at all.
  • Low daily or bi-daily dose of aspirin may help (50mg)
  • Use NSAIDs to treat the pain if required (Ibuprofen) 
And if there is a big problem, seek medical advice as they can do physio, surgery and "X" to treat the issue (where "X" is stuff I've never heard of before.)


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