Chronic pain, disability and adapting

Most of this site tells you to bend, kneel, arch and hold still, which quietly assumes a body that will do all four on request. Plenty will not. This page is for everyone who read those instructions and concluded, wrongly, that none of it was meant for them.

Consenting adults only. Everything on this page is about adults over 18 who have freely agreed to it.

Written from first-hand experience or extensive research by the editor.

Two people have told me, in almost the same words, that they had decided this was not for them because they could not get into any of the positions in the books. Both were wrong, and both times the fix took ten minutes of talking and a couple of pillows.

So here is the principle first. The activity adapts to the body, not the reverse. A session run lying down, with three pauses in it, that stops after fifteen minutes because that is what today allows, is not a watered-down version of the real thing. It is the real thing.

Hypermobility and Ehlers-Danlos

Worth taking first because hypermobile people turn up in this world in numbers anybody who has been around a scene for a while will have noticed, and because almost nothing written for them acknowledges it. Take that as a widely observed pattern rather than a figure I can source.

Two things change. The first is joints. Anything that subluxates under ordinary load will certainly do it in a position held for twenty minutes while somebody pushes against you, and the usual offenders are shoulders, hips and knees. That rules out a good deal of what this site recommends by default: arms taking weight, kneeling on a hard surface, being braced against a push. Support the whole body instead, and remember that fine at one minute is not the test.

The second is skin, and it causes more trouble between partners than the joints do. Hypermobile skin frequently bruises from very little, spreads those bruises further than expected, and takes longer to clear them.

The danger is not the bruise itself. It is that the person holding the implement is calibrating by what they can see, and what they can see is telling them a story about force that is not true. A light session can produce a backside that looks like an assault, and a top who trusts their eyes will panic and stop something that was going perfectly well.

So say it in the negotiation, in plain words: my marks are not a measure of what you did. Then agree what is. Verbal check-ins at fixed intervals work better here than anywhere else, and there is more on that at reading your partner.

Chronic pain, fibromyalgia and ME

The first casualty is the pain scale. Asking somebody who lives at a four whether this is a six is close to meaningless, and the usual traffic light system needs restating in terms of what is happening rather than how much it hurts: green means carry on, amber means change something, red means stop, and none of them are numbers. See safe words.

The second is that the bill arrives late. A session that felt manageable on the Saturday can produce a flare on the Monday that costs three days, and the flare is not proportional to how heavy the scene was. Duration, positions held and sleep lost afterwards all feed it. That is a different accounting problem from ordinary drop, and being brave about it changes nothing.

What works, in my experience of playing with people in this position, is short and unhurried. Twenty minutes of actual activity, generous pauses, then a long wind-down with warmth and food. The instinct to make the most of a good day by going long is the most expensive mistake available.

Backs, necks, hips and knees

Specifics, since general advice is useless here.

The two positions to drop are touching toes and bent over a table. Both load the lower back under sustained flexion, both are held by muscular effort, and both put the head below the heart for long enough to matter. If you have disc trouble, sciatica or a neck problem, neither belongs in your repertoire, and no amount of liking how they look changes that.

The two that adapt best are lying across a bed and kneeling on a chair. Lying face down with a pillow or two under the hips supports the whole body, keeps the spine neutral, presents the target properly and can be held indefinitely. If you take one thing from this page, take that. Kneeling on a well-padded chair is the upright alternative, with the pelvis tilting forward naturally and no forward bend at all, though it asks something of the knees.

Over a sofa arm is often the right compromise: hips supported, a moderate bend, and a height you can adjust with cushions until it stops asking anything of the back. What each one does is set out on the positions index.

Mobility aids and playing seated

All of this works sitting down. A wheelchair user can lean forward onto a table or a padded surface, can be reached from the side, and can perfectly well be on the giving end of everything here rather than the receiving end, which is a possibility people forget to offer.

Transfers get planned in advance, done slowly, and never made part of the drama. If moving from chair to bed is part of the evening, it happens before anything starts, with whatever help is normally used.

The rule I would not bend on: aids stay within reach. A stick, a frame or a crutch is not a prop and does not get moved across the room for effect. Taking away somebody's means of moving is a restraint, and a serious one, with more consequence than tying somebody down if the evening goes wrong or the building has to be left in a hurry.

If both of you genuinely want that, it needs its own conversation, its own limits and its own signal, and it is never something to improvise mid-scene. See negotiation.

Numb areas come off the list

Where sensation is reduced or absent, from neuropathy or nerve damage or anything else, that area cannot tell you it has had enough. It will not report a stroke landing wrong, it will not produce the flinch a top is reading, and the damage gets found later by looking rather than by feeling.

So it is not a target. Not lightly, not carefully, not with something soft. Work where sensation is intact and check the skin afterwards by eye, in good light, together. The general map is at where it is safe to strike.

Fatigue, and the day after

Build the session to finish while there is still something left. That is good advice for everybody and close to mandatory here, because emptying the tank costs days rather than hours.

Then plan the following day as part of the scene rather than as an afterthought. Nothing scheduled that cannot be moved, food already in the house, an agreed check-in by message. That planning is part of aftercare, and where recovery is slow it matters more than anything that happens on the night.

What to add to the negotiation

• What a bad day looks like from the outside, so your partner can spot one before you have to announce it.
• The signal for stopping when speech has gone, since pain and fatigue both take words away. Two taps on the nearest surface is the usual answer.
• Whether pain that was already there is allowed into the scene, or whether this is a sealed room the illness does not enter. Both are common, and they are completely different evenings.
• What help is wanted afterwards, and what help would be unwelcome. Plenty of people who need assistance in ordinary life do not want it from the person they have just played with.
• Medication timing, if any of it affects alertness, blood pressure or bruising.

Choosing pain when your body already hurts

People are shy about this one. Plenty of those whose bodies hurt anyway are drawn to this precisely because it is pain with an author and an end, arriving on purpose, at a time they picked. Pain you consented to is a different experience from pain that simply happens to you, and wanting the first when you get plenty of the second is not perverse.

The distinction worth being able to make is between choosing pain and punishing a body you have become angry with. Those look identical from outside and feel entirely different from inside, and only one of them leaves you better afterwards. If it is the second, more sessions will not fix it.