Debate of the day: A medical perspective look into why children should not be handcuffed


This article provided to you be guest writer Dr. Robert Rail. It includes editorial content which is the professional opinion of the writer.

Note: LEO’s- Refer to your departmental policies for further guidance 

Nationwide: The misconception and relatable misunderstandings of using of handcuffs on youth are unfortunately, as varied and diverse as are the inadequate training, general orders and policies that are written to oversee the well meaning, however short sighted, orders and their tragic repercussions.

To be more precise and understandable, let us first sort out what the words we live and enforce by mean.  A “child” is a person between birth and puberty and an “adolescent” is a person between puberty and adulthood” according to the American Medical Association.

Handcuffing 101

Handcuffs, or mechanical restraints, are the second most critically utilized piece of enforcement equipment after the police radio. The incidences of “use of deadly force” in an officer’s career, thankfully, are usually counted on the fingers of one hand.

The application and use of handcuffs has become a daily task with little or no thought given to the consequence of their application, as long as the handcuffing logic and mantra of “preventing escape”, “arrestee self injury”, “injury to officer/others” is the achieved goal.

Unfortunately, most police are not afforded the opportunity to engage in post certified, or post academy handcuffing training or timely recertification of training in their entire career.

This circumstance is a highly serious dilemma due to the increasing number of officers and arrestees injured by ineffective tactical skills. Too often it is improper application and the use of “more force” causes problems when appropriate skills with less force would have been sufficient to achieve securing the arrestee.

To cloud a truly confusing situation is the issue of “independently” offered training, where there are more suspect aspiring master trainers and methods of handcuff application than there are teeth on the handcuff ratchet bars.

Debate of the day: A medical perspective look into why children should not be handcuffed
(Adobe Stock)

In the world of training the two dominate variables are “how are the handcuffs applied?” and “who are the handcuffs put on?” The factor of the design of the handcuffs themselves has remained largely unchanged for decades with few dramatic innovations. This now brings our focus upon the issues of training, and who should we be handcuffing?

Handcuffs are not one size fits all. They are designed to defeat escape, self injury, injury to others, and only to be used for a brief transport or detainment time and only while the arrestee is under constant observation, after proper application and double locking.

All handcuffs are considered mechanical restraints, and all mechanical restraints must be tested and approved for use if carried by American sworn police officers and others. They are regulated, tested, and certified by the National Institute of Justice, (NIJ) under the authority of the United States Department of Justice.

The Mechanics

The smallest adjusted internal circumference of the average mechanical restraint is significantly larger than the small, diminutive size of a child’s wrist making for an incompatible and unsafe application.

The ratchet teeth and the internal pawl teeth of the cuff do not engage and consequently, pass beyond the point of engagement of the double lock safety feature. The internal pawl teeth will not interlock with the ratchet teeth for the appropriate “safe stop” design of all handcuffs.

This will cause the ratchet to continue tightening and slide beyond the double lock ratchet, safety stop feature of the pawl engagement, making it ineffective and useless.

Double locking handcuffs that have been closed beyond the internal pawl teeth is like engaging the deadbolt on an open door. Even if the double lock feature is engaged, the cuffs will continue tightening on a small child wrist, resulting in potential injury by means of the unrestricted guillotine like closure.  A major concern and consideration is the potential of the child sustaining “Green Stick Fracture”

Debate of the day: A medical perspective look into why children should not be handcuffed

According to Mayo Clinic, Child Orthopedics:

A greenstick fracture occurs when a bone bends and cracks, instead of breaking completely into separate pieces. The fracture looks similar to what happens when you try to break a small, “green” branch on a tree. Most greenstick fractures occur in children younger than 10 years of age. This type of broken bone most commonly occurs in children because their bones are softer and more flexible than are the bones of adults.” 

Insufficient training, overlooked supervision, and vague general orders have led some officers to, unfortunately, resort to securing both of a child’s wrists in one cuff, while other confused or desperate officers actually applied the cuffs above the elbows of the child.

Placing two wrists in one cuff is a rarely used adult tactical method that is used when proper equipment is not available. It is at the least, a poor and desperate choice in any high liability situation!

A Medical Professional Perspective

I reiterate, NEVER handcuff a child and when it is critically necessary to handcuff an adolescent, use great caution. Human bones do not fully ossify or harden until 22 years of age in males and 18 years of age in females.

Handcuffing directly subjects the child or adolescent to the potential of “Green Stick Fracture”. The use of ambulance or hospital soft restraints, applied under direct medical supervision, should always be the preferred enforcement decision.

Judge dismisses lawsuit over attempted handcuffing of boy who punched teacher
Child who attacked teacher being arrested in Florida – YouTube screenshot (courtesy of BklynBadBoy911)

In the safe and supportive learning environment that all schools are required by law to provide, one of the most critical and vulnerable groups is the children of our nation. Those first lessons taught sights and sounds, and experiences made, will shape and direct the path of their lives.

In a warm and encouraging learning environment with motivating and creative decorations on walls and whiteboards that are suitably low to be reached by the child’s hands, and tables and chairs so very and properly small, we must consider all of the child’s exposure from the viewpoint perspective of the child.

This includes seeing things in the child’s world as we seek a solution to harsh and unreasonable use of adult criminal enforcement procedures, conflicting and problematic policy, and general orders that complicate the officer- child relationship.

We must structure and encourage taking a moment to talk and calm a child in emotional crisis, and recognize the child and their needs in circumstances that even adults would find overwhelming.

I respectfully, and with hope, recommend that when a child is in contact with the law enforcement community concerning any incident, that the initiating situation, from contact to supervision, be of careful, understanding focus. This is a critical challenge to one and all concerned seeking a structured, child focused, societal and learning environment.

What must be addressed and focused on are the needs of the child, and the functioning of the educational and enforcement communities in support of the child. We can take the handcuffs off the child, We must always remember – just like pulling nails out of a piece of wood, the holes will remain; so too you can take the cuffs off a child but the mental trauma will always remain in their future thoughts.

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Debate of the day: A medical perspective look into why children should not be handcuffed

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