TJ Watt Dry Needling Injury
Understanding the T.J. Watt Dry Needling Incident: Safety, Training, and What Patients Should Know
Recent news that Pittsburgh Steelers linebacker T.J. Watt required surgery after developing a pneumothorax (partially collapsed lung) following a dry needling treatment has understandably raised concerns among patients and athletes.
Stories like this can create fear, especially when details are limited. Our goal here is not to sensationalize the incident or assign blame, but to provide clarity, explain what the scientific evidence actually shows about needling safety, and highlight why education, experience, and professional standards matter.
Key Points
T.J. Watt developed a pneumothorax following a dry needling treatment, but the team has not publicly disclosed who performed the procedure or under what credentials.
Serious complications from needling-based treatments are rare, but when they occur, they are most often linked to technical errors, such as improper needle depth or angle, particularly in high-risk areas like the neck and upper back.
Dry needling and acupuncture use the same acupuncture needle, but practitioner education, clinical training, and safety standards vary widely across professions.
Licensed acupuncturists undergo extensive, formal training in needle-based procedures, anatomy, and safety protocols, while dry needling training for other professions is not standardized.
In Pennsylvania, dry needling is not explicitly authorized by statute for physical therapists or athletic trainers, placing it in a regulatory gray area and underscoring the importance of transparency around practitioner credentials.
This situation is not the patient’s or athlete’s fault. Players and patients rely on organizations and clinicians to ensure treatments are delivered safely and within appropriate professional and legal boundaries.
Incidents like this highlight the need for clearer training standards, better regulation, and greater transparency across all professions that use needles in clinical care.
What Happened and What Remains Unclear
Public reporting confirms that T.J. Watt developed a pneumothorax after a dry needling session performed at the Steelers’ practice facility. What has not been publicly disclosed is who performed the treatment or under what credentials.
That lack of transparency matters. As of now, it remains unclear whether the treatment was performed by:
a physical therapist
an athletic trainer
an acupuncturist
or an outside contractor
Comments from within the Steelers’ locker room suggest the practitioner may not have been an acupuncturist. Linebacker Patrick Queen publicly distinguished between acupuncture and dry needling, explaining his own preference:
“Kind of two different things. One [acupuncture], you got to go to school for a longer period of time. There’s a whole much more scientific thing that goes into it. I don’t do the whole dry needle thing. I’m actually scared of dry needling, so I kind of stay away from that stuff.”
Queen went on to acknowledge that adverse events are uncommon, while emphasizing how small technical errors can matter:
“It is unfortunate. You could probably get dry needle a thousand times and never have anything happen, and it just probably a half an inch in the wrong direction.”
He also explained why the additional education required for acupuncture influences his decision-making as a player:
“I just feel, me personally, more comfortable with somebody that has a little bit more experience. Not saying anything wrong about anybody that did it or whatever, but that’s just me personally.”
Beyond questions of training, the absence of clarity also raises legitimate scope-of-practice considerations. In Pennsylvania, dry needling is not explicitly authorized by statute for physical therapists or athletic trainers in the same way that acupuncture is clearly regulated. By not disclosing the practitioner’s credentials, the team makes it difficult to determine whether the practitioner was operating within clear legal authority under current state practice standards.
This is not an accusation, but a systems-level concern. Clear disclosure protects athletes, practitioners, and organizations alike. When the type of practitioner and their scope of practice are not made public, it becomes difficult to assess whether appropriate training, authorization, and safeguards were in place.
We are still awaiting clarity on who performed the treatment. Until that information is made public, speculation isn’t helpful. What is helpful is understanding how incidents like this occur and how stronger training standards, clearer regulation, and greater transparency can help prevent them in the future.
Dry Needling Safety: What the Data Shows
Needling-based treatments, including acupuncture and dry needling, are generally considered low-risk when performed by experienced practitioners with appropriate training. Large reviews of the medical literature consistently show that serious adverse events are rare.
However, rare does not mean impossible.
Across acupuncture and dry needling research, pneumothorax shows consistent patterns:
It most often occurs when needling the neck, upper back, or chest wall
It is typically associated with excessive needle depth or incorrect needle angle
It is strongly linked to insufficient anatomical training and poor safety awareness
In other words, pneumothorax is not a random complication and not an inherent flaw of needling itself. It is usually the result of technical error.
Patrick Queen summarized this reality well when he said:
“You could probably get dry needled a thousand times and never have anything happen, and it just probably a half an inch in the wrong direction.”
That half inch matters, particularly near the lungs.
Education, Training, and Experience With Needling
One of the most important lessons from this situation is that not all needling education is equivalent, even though the same type of needle may be used.
Licensed acupuncturists complete extensive formal education that includes:
Detailed three-dimensional anatomy
Hundreds to thousands of hours of supervised clinical training
Explicit instruction in needle depth, angle, and safety zones
Managing adverse events and complications
Patrick Queen highlighted this difference clearly:
“One [acupuncture], you got to go to school for a longer period of time. There’s a whole much more scientific thing that goes into it.”
By contrast, dry needling training for physical therapists and athletic trainers varies widely by state and by continuing education provider. In many cases, it consists of short certification courses layered onto a professional education that was not originally designed around invasive needling procedures.
This does not mean physical therapists or athletic trainers are careless or unqualified clinicians. It does mean that needle-specific education and experience are not standardized across professions.
As Queen also noted:
“I just feel, me personally, more comfortable with somebody that has a little bit more experience.”
That perspective reflects a reasonable patient concern, not an attack on any profession.
Legal and Regulatory Gray Areas Matter
In Pennsylvania, where this treatment reportedly occurred, dry needling exists in a legal gray area for non-acupuncturists. While acupuncture is clearly regulated under state law, dry needling is not always explicitly authorized outside of acupuncture or medicine.
When scope of practice and training standards are unclear, safety standards tend to become inconsistent. Even at the highest levels of professional sports, this creates avoidable risk.
Importantly, this is not the athlete’s fault. Players trust their organizations and medical teams to provide safe care. If a practitioner believes they are adequately trained but lacks sufficient experience, the failure is systemic, not personal.
Dry Needling Scope of Practice and Legal Context in Pennsylvania
In Pennsylvania, the regulatory status of dry needling for non-acupuncturists remains unclear. Unlike acupuncture, which is explicitly regulated under state law, dry needling is not specifically authorized by statute for physical therapists or athletic trainers in the Commonwealth. Pennsylvania’s athletic training regulations define permitted practice and supervision requirements but do not list dry needling as an authorized intervention. Similarly, there is no clear language in the Pennsylvania Physical Therapy Practice Act explicitly permitting dry needling, which has led to the practice being widely described as a regulatory gray area within the state.
This lack of clarity is further underscored by the introduction of proposed legislation intended to formally define whether and under what conditions dry needling may fall within physical therapy scope of practice. The existence of such legislation suggests that the issue has not yet been conclusively settled. In this context, transparency around practitioner credentials and authorization becomes especially important, as clear disclosure helps ensure that treatments are delivered within appropriate legal and professional boundaries.
NOTE: This article reflects a review of public statutes and available regulatory guidance; it is not a definitive legal determination.
A Call for Higher Standards Across All Professions
This incident should not be used to scare patients away from needling-based care. Instead, it should prompt reflection and improvement.
Sports organizations should ensure that invasive treatments are performed by clinicians with extensive, documented training
Professional organizations should establish clear and consistent safety standards
Every profession that uses needles should examine whether current training requirements truly match the risks involved
Needles are powerful clinical tools. Used correctly, they are safe and effective. Used without adequate training, they carry unnecessary and preventable risk.
What This Means for Patients and Athletes
Patients and athletes have the right to ask:
What is your formal training with needles?
How much hands-on needling experience do you have?
What safety protocols do you use in high-risk areas?
At Morningside Acupuncture, treatments are performed by licensed acupuncturists with extensive education and clinical experience in needling-based care both within traditional acupuncture and dry needling. We focus on safety, transparency, and evidence-based practice.
Incidents like this are rare, but they reinforce why training, standards, and experience matter.
Frequently Asked Questions (FAQ)
Is dry needling dangerous?
Dry needling is generally safe when performed by experienced practitioners with appropriate training. Serious complications are rare and most often related to improper needle depth, angle, or anatomical error.
Can dry needling cause a collapsed lung?
A pneumothorax is extremely uncommon. When it does occur, it is typically associated with technical errors in high-risk anatomical regions, not with acupuncture or dry needling as therapies themselves.
Is dry needling the same as acupuncture?
Since it uses acupuncture needles, dry needling can be considered an acupuncture style that is focused on needling myofascial trigger points and tight muscles to relieve pain and restore range of motion. The difference in terminology lies in practitioner education, clinical training, and regulatory standards, not in the needle or the tissue being treated.
Who should perform dry needling treatments?
Ideally, needling should be performed by clinicians with extensive, formal education and hands-on training in needle-based procedures, particularly when treating the neck, upper back, or chest wall.
What should I ask before dry needling treatment?
Patients are encouraged to ask about training hours, clinical experience with needling, and safety protocols. These are reasonable and appropriate questions.
Is dry needling illegal?
The legality of dry needling depends on the state and the practitioner’s license. Acupuncturists can perform dry needling anywhere that acupuncture is legal - since the treatment uses acupuncture needles. In some states, dry needling is clearly permitted for physical therapists or athletic trainers. In others, including Pennsylvania, it exists in a legal gray area or is not explicitly authorized outside of acupuncture or medicine. Regardless of legality, the most important issue is whether the practitioner has sufficient education and experience to perform invasive needling safely.
Ready to Try Acupuncture & Dry Needling?
Whether you’re struggling with acute or chronic pain, acupuncture and dry needling may help restore mobility and reduce pain - quickly and safely.
📍 Conveniently located in New York City
🧠 Experts in trigger point therapy, acupuncture, and dry needling
Book your appointment today with the experts at Morningside Acupuncture, the top-rated acupuncture and dry needling clinic in New York City.
Let us help you move better, feel stronger, and live pain-free.
Additional Resources & Next Steps
Learn More: Visit our Blog for further insights into our treatment approach.
What to Expect: During your initial consultation, we perform a comprehensive evaluation to develop a personalized treatment plan.
Patient Stories: Read testimonials from patients who have experienced lasting relief.
Sources:
ESPN. (2025). Steelers’ T.J. Watt undergoes surgery after suffering collapsed lung during dry needling treatment.
https://www.espn.com/nfl/story/_/id/47287260/steelers-tj-watt-surgery-collapsed-lungESPN. (2025). T.J. Watt’s collapsed lung: What dry needling is, what went wrong, and what happens next.
https://www.espn.com/nfl/story/_/id/47289609/tj-watt-pittsburgh-steelers-collapsed-lung-injury-recovery-line-dry-needling-treatment-explained-questionsWhite, A., Hayhoe, S., Hart, A., & Ernst, E. (2001). Adverse events following acupuncture: Prospective survey of 32,000 consultations. BMJ, 323(7311), 485–486.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4101552/Pennsylvania Department of State. (n.d.). Practice standards for athletic trainers (49 Pa. Code § 18.509). Pennsylvania Code & Bulletin.
https://www.pacodeandbulletin.gov/Display/pacode?d=reduce&file=/secure/pacode/data/049/chapter18/s18.509.htmlMyopain Seminars. (n.d.). Pennsylvania dry needling laws and rulings.
https://myopainseminars.com/resources/us-rulings/pennsylvania/Pennsylvania House of Representatives. (2025). House Bill 2070: Clarifying dry needling within physical therapy scope of practice (Co-sponsorship memorandum).
https://www.palegis.us/house/co-sponsorship/memo?memoID=47651
Disclaimer: This web site is intended for educational and informational purposes only. Reading this website does not constitute providing medical advice or any professional services. This information should not be used for diagnosing or treating any health issue or disease. Those seeking medical advice should consult with a licensed physician. Seek the advice of a medical doctor or other qualified health professional for any medical condition. If you think you have a medical emergency, call 911 or go to the emergency room. No acupuncturist-patient relationship is created by reading this website or using the information. Morningside Acupuncture PLLC and its employees and contributors do not make any express or implied representations with respect to the information on this site or its use. For any legal interpretation of scope of practice in your state, consult a licensed attorney or regulatory authority.
Read more from our blog
