In mental health, healthcare and security environments, there are occasions where the use of rigid handcuffs may be necessary to maintain safety and control during a physical intervention.
When used appropriately, handcuffs can be an effective temporary control and restraint device that protects staff, the individual and others present. However, when complaints arise following incidents involving handcuffs, they typically focus on two areas:
- Was the use of handcuffs necessary?
- Were the handcuffs applied too tightly?
Both issues highlight the importance of proper training, professional standards and correct safety checks.
At UK Patient Care, we specialise in evidence-based handcuff training designed for healthcare, mental health and security professionals across the UK. Our training ensures staff understand not only how to apply handcuffs safely, but also the legal framework surrounding the use of force.
Why Proper Training IS CRUCIAL
Anyone applying handcuffs must be:
✔ suitably trained
✔ accredited in the specific type of handcuffs being used
✔ competent in safe application techniques
✔ knowledgeable about the law surrounding use of force
Without this foundation, the risk of injury, misuse, or professional complaint increases significantly.
Training ensures staff understand how to apply handcuffs safely, how to check for tightness and when to use them proportionately.
Correct Handcuff Application
When applying rigid handcuffs, technique matters.
The handcuffs should be held correctly, with the single bar used with controlled touch pressure.
Application may involve:
- pushing the handcuffs onto the wrist
- pulling the wrist into the handcuffs
- a combination of both
This controlled approach helps ensure safe, smooth application without excessive force.
Correct Wrist Position
Handcuffs should sit between the hand and the wrist bone knuckle, where the wrist bends.
A useful anatomical guide is the pisiform bone, located on the little finger side of the wrist. This small prominent bone helps identify the optimal placement for both effectiveness and reduced injury risk.
Correct placement improves control, reduces nerve compression risks and minimises unnecessary discomfort.
Checking Handcuff Tightness
Once the handcuffs are applied using the chosen technique (for example front stack or rear stack), the next critical step is checking for tightness.
This ensures the cuffs are not too tight and not too loose.
Handcuffs that are too loose can:
- slide up the arm
- reduce control effectiveness
- increase injury risk
- allow the wearer to rotate their wrists or potentially escape
To carry out an effective safety check, staff should follow a simple three-step process.
Ask – Look – Feel
Ask
The first step is to ask the individual how the handcuffs feel.
This can help gauge the level of discomfort or pressure, but it should never be relied upon as the only check.
Some individuals may exaggerate discomfort, while others may not communicate pain clearly, particularly in high-stress situations.
Look
Next, visually inspect the handcuffs.
Things to check include:
- is there a small visible gap between the cuff and the skin
- do the cuffs appear to be squeezing or compressing the wrist
- has the colour of the hand changed
- are there any signs of swelling or restriction
These visual cues can quickly identify potential problems.
Feel
The final step is a physical check of the handcuffs.
This is where many common mistakes occur.
Some staff check the gap at the rivet or backstrap of the cuff. However, this is incorrect because the distance between these two points never changes, which can give a false reading.
Instead, the correct check point is the midpoint between the rivet and the backstrap on either the single bar or double bar section of the cuff.
At the same time, ensure the little finger side or thumb side of the wrist is checked, where pressure injuries are more likely to occur.
This ensures there is a small, safe gap between the cuff and the wrist, confirming the cuffs are secure without causing harm.
Double Locking Handcuffs
After tightness has been checked, the cuffs should be double locked as soon as practicable and safe to do so.
Most handcuffs include double-locking pins located on the top of the cuff body.
Double locking prevents the cuffs from tightening further.
This is essential because without double locking:
- the cuffs may inadvertently tighten during movement
- the wearer may manipulate them to tighten further
- the risk of injury increases
If it is not possible to double lock immediately due to resistance or an unsafe environment, best practice is to document this as soon as possible.
Important Limitations of Handcuffs
Even when applied correctly, handcuffs do not remove risk completely.
They are a temporary control measure, not a guarantee of safety.
A person wearing handcuffs can still:
- kick or headbutt
- use their body weight to resist
- run away
- potentially operate a vehicle
For this reason, continuous supervision is essential.
A person wearing handcuffs should never be left unattended.
Professional Handcuff Training
UK Patient Care provides specialist handcuff training designed specifically for:
- mental health services
- healthcare staff
- security professionals
Training focuses on safe and lawful application, injury prevention, evidence-based restraint practice, documentation, accountability and practical scenario training.
The aim is simple: protect staff, protect patients and protect organisations.
We have end user and train the trainer options available. More about these courses can be found on our handcuff training pages:
Handcuff Training Course | Rigid Handcuffs & Soft-Cuffs
Handcuff & Soft-Cuff Instructor Programme – UK Patient Care
Email: info@ukpatientcare.co.uk
Call: 0113 873 0715
