Dry needling has become increasingly common in sports and performance settings, often discussed as a way to address tightness, myofascial pain, or movement limitations. With growing use, it’s crucial to understand dry needling risks and benefits for athletes, what it does, what it doesn’t do, and how to weigh risk versus benefit when selecting interventions for high performers.

What Is Dry Needling?

Dry needling involves inserting a thin needle into the muscle or surrounding tissue to temporarily reduce pain or perceived tightness. Athletes often use it because it can produce short-term symptom relief, making movement or training feel easier on a given day. Physiologically, dry needling works primarily through nervous system modulation, not by mechanically changing muscle or connective tissue. The needle acts as a sensory input, altering pain perception and muscle tone, but the results are equivalent to non-penetrating interventions like massage, manual pressure, or foam rolling.

Why Would A Provider Choose To Use Dry Needling

Providers often favor dry needling for several reasons. Many clinicians report anecdotal improvements in patient comfort or movement. The technique also feels specialized and professional: inserting a needle with sterile gloves into a targeted area can give both provider and athlete a false sense of confidence in the intervention. Additionally, athletes sometimes request dry needling because they like it (don’t ask me, ask them) and/or it feels like an “advanced” therapy, even when simpler, lower-risk approaches could achieve similar results.

TJ Watt Dry Needling Incident

Recently, NFL linebacker TJ Watt suffered a collapsed lung following a dry needling session. While serious complications are rare, the incident illustrates a key point: dry needling carries more risk than many other tools that produce similar outcomes, particularly when applied near the chest or neck. Unlike low-risk options such as foam rolling or manual pressure, dry needling introduces risks, including infection, nerve irritation, and rare but serious complications (less than .01% of cases). It is also restricted or not permitted in some states, or limited to specific licensed providers.

Still, some athletes elect to use it, often based on a misunderstanding or outdated information (what we call ‘The Nope’) that the needle is required to ‘release deeper tissues’ or target a ‘fascial trigger point,’ as conveyed by providers or teammates.” (see more NFL players’ thoughts on dry needling here).

What Is The Benefit of Dry Needling?

Systematic reviews consistently show that dry needling provides modest, short-term pain relief with no clear long-term functional advantage over other symptom-modulating interventions like massage, manual therapy, or exercise.

Importantly, there is no strong clinical practice guideline that endorses dry needling as a primary treatment for musculoskeletal conditions. Studies even show similar outcomes when the needle is replaced with non-penetrating stimuli (e.g., a toothpick lightly touching the skin), reinforcing that dry needling’s effects are neurological rather than structural. With that being the case, instead of getting pricked by needles, why not spend the time investing in what drives the neurological system (Read more here).

This brings us to a critical performance question: if two interventions produce similar short-term symptom relief, but one carries greater risk, why choose the higher-risk option?

Bottom Line

Dry needling may feel specialized, and it can provide short-term relief, but the evidence and safety profile suggest that low-risk interventions can often achieve the same results. Athletes and high performers should weigh the risk vs benefit carefully and prioritize interventions that protect performance and readiness.

FAQ

Q1: What is dry needling, and how does it work?
A: Dry needling involves inserting a thin needle into muscle or surrounding tissue to temporarily reduce pain or perceived tightness. Its effects come primarily from nervous system modulation, not mechanical changes to tissue.

Q2: Has dry needling caused serious injuries in athletes?
A: While rare, serious complications can occur. NFL linebacker TJ Watt recently suffered a collapsed lung following a dry needling session, highlighting the potential risks if needles are applied near the chest or neck.

Q3: Are there safer alternatives to dry needling for athletes?
A: Yes. Techniques like massage, foam rolling, manual pressure, and breathing strategies can reduce symptoms and modulate the nervous system with lower risk, without using needles.

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Author:

Dr. Dillon Caswell, PT, DPT, SCS

Doctor of Physical Therapy | Board Certified Sports Specialist

Hope Evangelist | Top-Selling Author & Speaker | Human Performance Expert