I engage in rough body play (the generally accepted term within the kink scene) at the extreme end of the spectrum as both Domme and sub in both my personal life, and (usually lighter) in my professional life. If done with control by someone who is intimately familiar with the safe and fun methods of spanking, slapping, skin torture, punching, kicking and face slapping it's relatively low risk provided both parties know how to handle themselves. Compared with bondage, which runs serious risks of permanent nerve damage, the most you're likely to get with rough body play is sore muscles, some petechia and bruising. Even this requires an intensity of play few people who aren't really into it would tolerate.
I personally both when working as a pro-switch and currently only offered bottoming to such play to individuals I have personally instructed in safety and techniques, or who have been trained by one of two individuals in the scene I trust to teach it. If an individual doesn't meet these criteria, I tend to suggest a session where the first part is sexy skills training, and the second is controlled play. I only do this because of my extensive history of such play in my personal life- I feel comfortable playing teacher while enjoying the activities.