Suspension

What is suspension?

Suspension (Dutch: ophanging) is bondage in which the full body weight hangs from rope, chain, or straps and no part of the body still has support from the floor. The weight runs through the wraps on the body to a single point in the structure above. It is the heaviest form of rope work, and the only one in which hanging still is itself the danger.

What a suspension looks like in practice

Most suspensions are horizontal, not upright, and they last shorter than people think.

Here is what the common form looks like. Around the torso and upper arms goes the harness this site calls gote shibari. The first line hangs from that; the second from the hips or a drawn-up leg. Two lines are enough to tip someone into the horizontal, face toward the floor or to the side. From that moment nothing touches the ground anymore, and there is no muscle left that can make even half a correction.

That exact setup is in the only study that mapped the injuries from rope bondage. In Cureus, Khodulev and colleagues describe how the rope on their participants lay “in the middle third of the upper arm” precisely to make a horizontal or sideways suspension possible, with the hands usually in a tie behind the back. Of the sixteen nerve injuries, thirteen were on the radial nerve. The suspensions in which that happened lasted five to twenty-five minutes.

Five minutes. That is the shortest suspension in that series after which someone could no longer extend their wrist.

Why hanging motionless is the danger

It is not the height that does it, and not the fall. It is the standing still.

The moment the floor is gone, the muscle pump in the legs falls quiet. Blood sinks to the lower legs and stays there. For the European Journal of Applied Physiology, Rauch and colleagues hung twenty healthy volunteers in a seat harness for up to an hour. Twelve of the forty trials had to be stopped early because the participant was about to faint: on average after 44.7 minutes, the fastest after 13.4 minutes, the slowest after 59.7. Thirty percent of the trials, in healthy people who did nothing but hang.

There is one sentence in that study that changes everything about how you have to approach it. In the participants who lasted, heart rate and blood pressure did not change. In the participants who passed out, heart rate and blood pressure dropped only just before the moment itself. So it is not that the vital signs slowly drift the wrong way and you intervene: the blood sinks, the blood vessels in the legs dilate, and then the vagus nerve gives the command, all at once, that slows the heart. The authors write it plainly: the time to that moment is unpredictable.

The other side is just as clear. In the participants it happened to, all symptoms were gone within five minutes once they were lying flat.

Why people have themselves suspended

Because in a suspension there really is nothing left to do, and that is an experience you cannot create on the ground.

In floorwork you can still shift, turn your head, move your weight a centimeter. In a partial you still balance on one foot. In a full suspension there is no movement left that changes anything. The encyclopedia describes the effect as a strongly heightened sense of vulnerability and inescapability, and for some people the opposite as well: the feeling of floating.

• For whoever hangs the last task falls away. Even the task of keeping your balance has been handed over, and what remains is breathing and feeling.
• For whoever ties this is the moment the arithmetic comes to the front: where the weight runs through, how long it has been hanging, and what you will do if it goes wrong.
• For a couple the gain is rarely the photo. It is the memory of the point where one had the other completely in hand.

What it does not do belongs right here too. A suspension does not make a gentle evening more intense and does not restore trust that was not there. It is the most expensive way to get a feeling that three wraps around the upper arms also give, and it is the only rope form in which someone else’s body hangs from your judgment.

How people build a suspension

Almost never alone, and almost never without the point above having been arranged months in advance.

1. The point first, and separate from the evening. A beam, a ring, a frame: it is the only link no one can check partway through.
2. The harness that catches the weight. There is one case in the Khodulev series that fell outside the main group because there were too few rope turns, poorly distributed over the body, and the tie shifted during the session. That participant hung for a few seconds and needed a month before both arms worked again.
3. Going from partial to full. The last bit of skin still touching the floor is usually a toe, and it disappears without anyone announcing it.
4. Staying brief. In the venue three to ten minutes is common; whoever hangs longer hangs longer than the published injuries needed.
5. Coming down. This is the hardest part, and the part that is practiced least.

The room is part of it. In rented play spaces in the Netherlands, suspension points are part of the setup, and that is no accident: it is the only BDSM practice in which a piece of the building takes part.

Misconceptions about suspension

“Suspension trauma is an injury.” It is not, and the name has been officially rejected. The research report the UK Health and Safety Executive commissioned in 2009 states that “trauma” is an unfortunate term and is better replaced with syncope: fainting. No tissue is damaged. There is a circulation that gives up.

“Whoever you take out of the rope has to stay sitting upright first.” This is the most stubborn rule in the rope scene, and it has been checked twice and shot down twice. That same report concludes that nothing needs to change about the ordinary first-aid rule of laying a groggy or unconscious person flat, not even after hanging in a harness. The guideline of the Australian and New Zealand Resuscitation Council is even more direct: some organizations recommended half an hour of sitting and not lying flat, “this review has found no evidence for that practice and it may be harmful”.

“It goes wrong if it lasts too long.” In Rauch’s test subjects the spread was thirteen to sixty minutes and completely unpredictable, and in Khodulev the nerve injury arose after just five. There is no safe duration you can agree on; there is only a short duration that reduces the chance.

“Higher is more dangerous.” For what happens inside the body, the height makes no difference. Hanging motionless fifteen centimeters above the floor does exactly the same to the circulation as two meters. What the height changes is what happens if something breaks.

What I see myself

Of everything I do with rope, this is the only thing I hold off on location. I am Victor, a gigolo and psychotherapist, and I have tied for twenty-five years, but I cannot assess a suspension point in someone’s home, and so I hang no one from it.

In the conversations I have about it, women who want a suspension almost always describe the image and rarely the duration. They have a photo in their head of someone floating horizontally. That image in reality lasts three to ten minutes, and it is exactly that long because something can already happen in those minutes.

And then the practical thing, which strikes me every time: reporting comes naturally with pain and not with nausea. About a tingling hand you hear within thirty seconds. About dizzy, warm, and a little queasy you don’t hear, because it does not feel like a problem but like part of the rush. Those are precisely the warning signs the research report lists.

What you can do yourself

• Ask about the suspension point before you look at the rope. What bears it, who installed it, and where does the force in the structure end up? For comparison: US labor law requires, for one worker on a fall protection line, an anchorage that supports at least 22.2 kilonewtons. Over two thousand kilos, for someone who hangs from it for minutes at most.
• Don’t trust your eyes. In Rauch, heart rate and blood pressure did not change in the participants who came through it well, and dropped only at the moment itself. A calm face is therefore not a measurement, and the question has to be about dizzy, nauseous, warm, and tingling.
• Lay someone who passes out flat, however you were taught. Two national bodies have checked the sitting rule and found no evidence for it; in Rauch the symptoms were gone within five minutes flat.
• Agree who is there only to take someone down. One person who does nothing else, does not film and does not play along, and who has the scissors and the key on them.
• Practice the descent before you practice the hanging. Coming down under time pressure is the action practiced least in the venue and the one you alone need in an emergency.

More on suspension

Within this glossary, partial suspension is the step before, with the difference that the floor still bears part of the weight there and the standing leg keeps the circulation going, and shibari gives the whole tradition with its four ascending forms side by side. On the blog, the art of bondage describes how the first ties go.

Off this site, the Rauch experiment is open on the internet; it is the only study in which people were actually suspended with measuring equipment attached, and the graphs show how little there is to see before it goes wrong. If you want to check why the first-aid rule the scene passes on is wrong, download report RR708 from the UK Health and Safety Executive: chapter 3 lays out every recommendation with its level of evidence. The HSE’s own page is now offline; the full pdf is at eLCOSH.

Where this fits on this site

I don’t offer suspension, and that is not modesty but the only honest outcome of everything above: I cannot assess the structure at an address I don’t know. Rope on the ground is possible, and so is the feeling of your weight being taken from you. What happens during a BDSM date and what we go through beforehand is on that page.

Sources

• Suspension syndrome: a potentially fatal vagally mediated circulatory collapse. An experimental randomized crossover trial. Simon Rauch, K. Schenk, G. Strapazzon, T. Dal Cappello, H. Gatterer, M. Palma, M. Erckert, L. Oberhuber, B. Bliemsrieder, H. Brugger & P. Paal, European Journal of Applied Physiology 119(6), 1353–1365, 2019 (DOI 10.1007/s00421-019-04126-5; PMID 30895459; volume, issue, and pagination checked against Crossref, which gives only initials for the ten co-authors). Experimental, randomized crossover trial with twenty healthy volunteers in a seat harness, up to sixty minutes. Provides that twelve of the forty trials (30 percent) were stopped early because of imminent fainting, on average after 44.7 minutes with 13.4 as the fastest and 59.7 as the slowest; that heart rate and blood pressure stayed unchanged in those who came through it and dropped only just before the event in those it happened to; that the blood pools in the lower-leg veins but a vagal response ultimately causes the loss of consciousness; that the time to that moment is unpredictable; and that all symptoms disappeared within five minutes once the participant lay flat. A seat harness is not a rope tie and a test setup is not a scene; that the physiology is the same in both cases is an inference of mine and is not in the article.
• Evidence-based review of the current guidance on first aid measures for suspension trauma. A. Adisesh, L. Robinson, A. Codling & J. Harris-Roberts (Health and Safety Laboratory) with C. Lee & K. Porter (University of Birmingham), Research Report RR708, Health and Safety Executive, 2009. Systematic evidence review commissioned by the UK Health and Safety Executive, full pdf read. The original HSE page now returns 404; the pdf is available in full at eLCOSH, CPWR’s professional library for construction safety. Provides the finding that “trauma” is an unfortunate term better replaced with syncope; that no scientific literature exists testing the half-upright positioning of a rescued person; the recommendation to leave the ordinary first-aid rule of laying flat unchanged, even after hanging in a harness; the recommendation to take someone with warning signs of fainting out of the suspension as quickly as safely possible; and the list of those warning signs: light-headedness, nausea, a feeling of warmth, tingling or numbness of the arms or legs, anxiety, distorted vision, or the feeling of being about to faint.
• Guideline 9.1.5. First Aid Management of Harness Suspension Trauma. Australian and New Zealand Committee on Resuscitation, April 2021 (search date January 2020). Clinical guideline. Provides the description of the mechanism as low blood pressure from blood pooling in the legs combined with increased vagal activity that slows the heart; the report from more than ten minutes in a harness; the advice to free the person and place them in a position of comfort, preferably lying down; and the literal finding that this review found no evidence for the previously recommended half hour of sitting and not lying flat, and that the practice may be harmful.
• Acute Radial Compressive Neuropathy: The Most Common Injury Induced by Japanese Rope Bondage. Vasily Khodulev, Artsiom Klimko, Nataliya Charnenka, Marina Zharko & Hanna Khoduleva, Cureus 15(5), e39588, 2023 (DOI 10.7759/cureus.39588; PMID 37384078; full text read via Europe PMC). This page uses from that series only what concerns duration and position, because the numbers and the cases are already on the shibari and partial suspension pages. Provides that the rope usually lay in the middle third of the upper arm to make a horizontal or sideways suspension possible with the face down or to the side and the hands in a tie behind the back; that the suspensions in which injury arose lasted about five to twenty-five minutes; that thirteen of the sixteen injuries involved the radial nerve; and the case kept outside the main group in which the participant hung for a few seconds after few and poorly distributed rope turns and needed a month to recover.
• 29 CFR 1926.502. Fall protection systems criteria and practices. Occupational Safety and Health Administration, United States. Federal labor regulation. Provides paragraph (d)(15): an anchorage for personal fall protection must be independent of any anchorage supporting a work platform and, per attached worker, support at least 5,000 pounds (22.2 kN), or be designed under the supervision of a qualified person with a safety factor of at least two; and paragraph (d)(16)(ii): the system must limit the arresting force on the body to 1,800 pounds (8 kN) when a harness is used. Construction-site regulation, not written for bondage; used here as a benchmark for what is asked of a suspension point where it is written down.
• Suspension bondage. Wikipedia. Provides the description of what suspension does to someone: a strongly heightened sense of being vulnerable and inescapably held, in others the feeling of floating instead. A volunteer-written entry, not used here for a safety claim.
• OPHANGING. Woordenboek der Nederlandsche Taal via the Geïntegreerde Taalbank of the Instituut voor de Nederlandse Taal. Provides the only Dutch entry: “Het ophangen, in de hoogte doen hangen van iets; vooral om het daar eene (blijvende) plaats te geven of voor ieder zichtbaar te doen zijn” (the hanging up, suspending of something in the air; chiefly to give it a permanent place there or to make it visible to all). It is about objects, not people. For suspension the WNT gives zero entries.
• Newspaper archive of the Koninklijke Bibliotheek (Delpher). Searched through the SRU service on the DDD_artikel collection. Provides 34,303 articles with ophanging, of which 11,215 with the compound wielophanging (wheel suspension), and 6,475 with suspension against five with shibari and zero with kinbaku or touwbondage (rope bondage). In the newspaper the Dutch word belongs with cars and gallows; that is why the scene keeps the English one.

Related terms

• Partial suspension. The step before, in which the floor bears part of the weight and the standing leg keeps the circulation going.
• Shibari. The Japanese tradition in which suspension is the top rung and most people never get higher than the second.
• Gote shibari. The harness around the torso and upper arms, and exactly the spot where the rope lay in Khodulev’s study.
• Rope bottom. The person who hangs, and from whom the report about dizziness has to come.
• Rigger. The person who lays the rope and chooses the suspension point.
• Carabiner. The metal between rope and point, with the kilonewtons that should be marked on it.
• Hoist. The pulley system used to haul, and what that does and does not change.
• Panic snap. The closure that opens under load, and why it is not the answer here.