What We Don’t Know About Bondage Injuries (And Why Someone Is Finally Asking)

Foto von Nish Gupta auf Unsplash

For more information about Jess's research and information on how to participate, scroll to the bottom of this article.

I’m sure we are all familiar with the feeling of knowing something is true but having no way to truly back it up. We’ve seen it in the community; it has been spoken about, and yet… where is the research? What do we cite when someone adamantly demands, “Well, what are your sources for that?”

Well, this is why I hopped on a call with my friend and colleague Jess Helmer to keep you updated on what’s going on behind the scenes of the bondage research world.

Anyone who’s spent time in ropes has a mental catalog of injuries: their own, a partner’s, something they watched happen to someone else across the room at a play party and noted down as a lesson. After all, nerve damage gets talked about constantly, almost to the point of becoming shorthand for “bondage injury” itself. However, ask how common it actually is relative to everything else that can go wrong, or whether the person tying is at any real risk themselves, and the conversation runs dry fast.

Community knowledge fills some of that gap. It always has. But community knowledge and formal research answer different questions, and right now, on this particular topic, formal research has barely shown up.

And this is the gap Jess is working on closing! As a PhD student in a quantitative psychology program, with a rope background of their own and several years now spent working at the crossroads of kink and health, they have now launched their study specifically on bondage injuries. You heard it, folks, we’re finally going to be learning more about the fuller picture of what happens to bodies during bondage and how often it happens.

So do read on for more on what we ended up talking about. :)

Starting Broad on Purpose

“Our strategy was to stay broad and see what we can do with high-level questions that will hopefully motivate and inform future research on this,” Jess told me. “A big research question we had was: what are the types of injuries people are encountering, and where are they encountering them (…). Trying to get a better understanding of the nature of the injuries people are experiencing, and how common different types of injuries are, especially relative to each other.”

That last part echoed my initial thoughts on the topic, because of course, it is one thing to know nerve injuries happen, but it’s another to know how they rank against everything else — circulation issues, joint strain, skin damage, the whole range of things bondage can do to a body — in terms of actual frequency. Jess pointed out that the community’s existing injury information has understandably centered nerve damage, “and of course that’s important, but it’s not the only type of injury.”

The survey is therefore built to ask about a wide range of possibilities without steering people toward the answer everyone already expects to hear.

The study itself, as they described it, is relatively (and refreshingly, in my opinion) general. We’re starting from the very start.

“The study we’re currently running is just a cross-sectional online survey. It’s pretty short, and it mostly goes through some very basic demographics, people’s overall experience with doing bondage, and then whether they’ve experienced any injuries.”

No experimental manipulation, no lab visits, nothing that requires the kind of institutional infrastructure that would put this out of reach for a researcher working on a topic I see drastically underrepresented (phew!). So to see it being approached in such an honest way, FROM a community member at that, without too much institutional push and pull, is a comforting thing.

One thing I also found interesting was their comparison to sports injury research. They are drawing on that field’s methods for asking people about the impact an injury has had on their lives, and for thinking about relative risk in an activity that isn’t a constant exposure.

“This isn’t something where you’re encountering the risk all the time; there’s kind of a contained environment in which you’re encountering it,” they said. “So I think there’s some overlap in the nature of it that we can draw from that world as well.”

Not only do I think that is a fantastic way to look at it, but I also love how it simply treats bondage as a physical activity with a risk profile, in the same category as anything else people do with their bodies, rather than something that needs to be studied through a different, more suspicious lens. 10/10 stuff.

The IRB Question

I wanted to know how the institutional review process went, because this is usually where researchers doing kink-adjacent work brace for a fight. At least from my experience. Which is why Jess’s answer surprised me a little, albeit positively so.

“We went through my institution’s IRB and honestly encountered no issues with the fact that it was about kink and bondage, which was very surprising to me,” they said. They think that may have to do with how carefully the study was designed around anonymity.

They collect minimal demographics, remaining aware of the risk specific to small communities: collect enough demographic detail and the combination of answers can identify someone even without a name attached, especially in areas where kinksters are few and far between. In those cases, ask about region on top of everything else, and suddenly a handful of data points narrows down to one specific person. So they don’t ask about region. They don’t ask about much at all beyond what the research actually needs. How nice is that?

Jess was, however, honest about the anticipatory anxiety that comes with the peer review stage ahead, as well as the more public broadcasting of the research. “It’s tough to be researching this sort of stuff, because you’re always kind of anticipating problems, and you never really know when you’re going to run into them with people not feeling great about the type of research that you do.”

That made me chuckle, because I sure can relate to the looming feeling of doom every researcher is familiar with as they think of a contradictory review option. Which is an issue that especially does make a difference for kink researchers, given the topic itself (despite the growing amount of research) remains controversial in some circles.

What keeps them steady through that uncertainty is fairly simple: “I just try to ground myself in the fact that people are getting injured. That’s a real thing. I want to help see what I can do to at least provide more information about risks, so people can make more informed decisions. None of this is about telling people not to do any one thing. It’s just about providing information.”

Tops Get Hurt Too

When I asked what’s stood out to them so far, they mentioned something that, funnily enough, did quite align with the reason why I created Dominant Discourse. I do promise this was not staged! But the most surprising thing was indeed the extent of the injuries to the person doing the tying, not just to the person being tied.

“I think, maybe, like we were talking about before, people may not expect to think about tops getting injured, but we’re definitely accounting for tops getting injured in this work,” they said. “And there have been top injuries. I feel comfortable saying that there have been injuries by tops that have been reported, and I think that’s not surprising, but it’s much less talked about, and worth everyone knowing the risks we’re talking about.”

I think this is one of the more useful reframes to come out of the whole conversation. The dominant cultural image of a bondage injury is a bottom with nerve damage from a tie left on too long or too tight. And while that’s worth studying, it’s only part of the picture. Repetitive strain, pulled muscles, awkward positioning held for extended periods, the physical toll of suspending someone else’s weight… Those rarely get the attention they deserve. Which does lead me to wonder whether that’s because tops are less likely to talk about it. Or perhaps, partly because nobody’s really been asking? In either case. I’m quite glad Jess is asking.

Wearing Two Hats

Jess has a foot in both worlds — researcher and community member — and I was curious how they manage that without one identity undermining the other.

“It’s tough. I honestly don’t know what the blueprint is for that,” they said. (Relatable).

Their approach, for now, is to be explicit about which role they’re occupying in a given moment, something like announcing that they are putting their researcher hat on before diving into a conversation about the study. What surprised me was which direction they feel more exposed in. “My research self has been very welcomed into rope spaces. I feel more nervous about my fun hobby side being welcomed into a professional space. That’s so nerve-wracking for me.”

They described its inconsistency, too: long stretches with no bad reactions that lull you into thinking it’s all fine, followed by one dismissive or shocked response that undoes that sense of safety. “It’s interesting having to not just defend your research from a ’worth as research’ standpoint, but also from a shock-value standpoint — people just seem surprised and caught off guard.”

I told them I related to a version of this myself, the instinct to hold back in community spaces because being the person who’s “read the studies” can come across as condescending even when that’s the last thing you intend. It’s a strange kind of double vigilance, managing how you’re received from two directions at once, and I don’t think either of us has fully solved it.

As for how open they are about the research outside of academic and community contexts, they added, “I talk about it when asked, but my day-to-day work is very different from this — much more statistics-focused. So in some ways it just doesn’t come up too much.” They mentioned wanting to be braver about bringing it up more, though they was honest that they aren’t quite there yet.

Shows you folks that even when it’s part of our job, it does take some bravery. Truly, all of us are works in progress.

To the Healthcare Providers

I asked what they wish healthcare workers understood about bondage injuries, and their answer was less about clinical specifics and more about the interaction itself, which makes sense given the many occurrences of medical misunderstandings around kinks that happen in consultation rooms.

“We don’t have great data on how many people do bondage — especially how many do it often enough that it’s realistic they might be encountering injuries,” they said. “But it’s certainly possible that a healthcare worker might be encountering someone with bondage injuries who may not feel comfortable sharing with them that this is from bondage.” Their point is that the injury itself is only part of what a provider needs to manage well. The bigger variable is whether the patient trusts the space enough to explain what actually happened.

“I think the best thing a healthcare professional can do is be very clear that they are a safe person to share this with, so they can better understand the nature of the injury, what caused it, and what’s important surrounding it getting better and the treatment that’s needed.”

They acknowledged the fear is reasonable — plenty of people have good reason to expect a demeaning or condescending reaction, and that expectation alone keeps important information out of a patient’s chart. A provider who signals openly, without needing to be asked, that this kind of disclosure won’t be met with judgment changes what the patient is willing to say, and that changes what kind of care they get.

Advice for Anyone Starting Out

I closed by asking what they’d tell someone early in their career who wants to research a topic that carries a decent amount of social stigma.

“If you read a specific paper on the internet, you can probably try to contact the authors of that paper, which can give you a good starting point,” they advised. “People who write papers are usually interested in those topics and interested in promoting work in those areas. So I’d expect they’d be able to give some guidance on where might be a good place to start, where might be a good group to get involved in.” That’s essentially how their own path started, through TASHRA, and they have since built on that through their current work with the Sexual Medicine Research Team (SMRT) that overlaps meaningfully with kink research even though it isn’t their primary focus.

It’s advice that sounds almost too simple, but I have to admit, that’s where I started too. Stigmatized research areas don’t have the wide, obvious on-ramps that more mainstream fields do. You often can’t just apply to a program and get slotted into a lab that already exists, at least not in most places. Most often, you find the handful of people already doing the work, and you ask them how they got there.

Where This Leaves Us

Jess’s study is still collecting data, and the finer details of what it will report are still taking shape as more voices chime in. The core questions are already public, though. Jess, being a pretty big open science fan (which I sure appreciate) and preregistered the study on OSF (https://osf.io/g9w8a/overview), which commits it to looking at three things: the common locations on the body where bondage practitioners have been injured, the common types of injuries (abrasions and lacerations, for example), and the activities that caused them, and how age, gender, common health conditions, and length of bondage experience affect injury rates.

The goal is a starting point, something broad enough to reveal where the actual pressure points are, so that future research has somewhere specific to go. Given how little exists in the formal literature right now, that starting point is absolutely crucial.

After all, this information isn’t being put together to tell anyone what to do or not do. It’s about making sure the information exists at all, so the people making these decisions about their own bodies are making them with something more than word of mouth and personal anecdote to go on. That’s a low bar in most areas of health research. In this one, it’s still ahead of us. And I sure am honored to know the fantastic human who's making it happen.

A Note From Jess: If you participate in bondage, we would love for you to take this survey! Despite many reports of injuries from bondage, some of them severe and long-lasting, very little formal research has been conducted on the prevalence and characteristics of bondage injuries. Whether you’ve experienced an injury or not, your participation in this anonymous online survey (~15 minutes) will help develop a more precise understanding about the risks of bondage! This survey is open to anyone who is age 18 or older, is located in the U.S., and has ever participated in bondage (regardless of whether or not you have been injured). Click here to take the survey!