Pressure Point Injury Survey

The following survey is being conducted to research the long term effects of pressure point striking during practice. The results will be published once they are analyzed. Please take a moment to fill out the form.

How old are you?   

What is your sex?   male female

What medical problems do you have? (please list)  

Do you take any medications? (please list)   

What style of martial art(s) do you study?   

How many years have you been training?    less than 1 1 2 3 4 5 6 7 8 9 10 15 20 25 greater than 25

How many hours per week do you train?     less than 1 1 2 3 4 5 6 more than 6

Do you strike pressure points during practice? (kyushojitsu, dim mak)    yes no

Has anyone ever practiced striking pressure points on you?    yes no

        If yes, how many times per week?    never only once constant 1 2 3 4 5 6 daily

        For how many years?    less than 1 0 1 2 3 4 5 6 7 8 9 10 more than 10

        Duration of pressure point striking during each practice?    5 min or less 10 min 15 min 20 min 30 min 1 hour greater than 1 hour

         What areas have been struck on pressure points? (check all that apply)

                    head and neck      arms        legs        chest        abdomen    groin     back

Do you have any pain or numbness? yes no

        If yes, where do you feel it? (check all that apply)

                    head and neck      arms        legs        chest        abdomen    groin     back

        How many times per week do you have pain or numbness?    0 1 2 3 4 5 6 daily 1x per month 2x per month 3x per month

        For how many years have you had pain or numbness?    less than 1 1 2 3 4 5 6 7 8 9 10 more than 10 never

        How long do the symptoms last when you have them?    seconds 5 min or less 10 min 15 min 20 min 30 min 1 hour greater than 1 hour

        How would you describe the pain or numbness? (check all that apply)

                    sharp    dull     shooting     aching     burning   electric     tingling    numbness   weakness

Have you suffered any injuries from having pressure points struck on you? (please list)   

Would you be willing to answer additional questions about pressure point injuries? (if yes, please list email)

Thank you for contributing to this research