12/13/2025
With the news coming out about Pgh Steeler TJ Watt's dry needling lung injury, I thought I'd explain a bit more in depth about what most likely occurred and the behind the scenes fight happening between Licensed Acupuncturists (LAc) and Physical Therapists (PTs) and others who are employing these treatments with minimal knowledge, practice, or in depth training.
Dry Needling is a form of acupuncture used to release trigger points in muscles. There are many styles and techniques in acupuncture, and this is just one of them. In the past decade or so, many PTs have been taking a short course in dry needling which is around 56 hours total. A few weekends, that's it.
Licensed acupuncturists, on the other hand, attend a 3-4 year Master program with over 3000 hours of instruction, practice, and training. Acupuncture is one part of a full internal medical system. Even if PTs stay strictly using needles on muscles, they don't understand what they could be affecting in other ways. Aside from this, a huge part of acupuncture school is learning to needle at the correct depth and angle for every point and area on the body.
Several years ago, some PA acupuncturists and many of the PA Acu Board members including me, traveled out to Harrisburg to attend a hearing on whether or not PTs should legally be allowed to add "dry needling" to their scope of practice. The hearing came out in our favor, and the PTs were told if you want to practice acupuncture, then you can go to acupuncture school, pass the boards, and get an acupuncture license.
They keep doing it anyhow with no repercussions from their own board when reported. Overall, it remains in a "grey area" because due to acts already on the books, the PT Board can't pre-authorize it without a change. A new act HB2070 was introduced just last week with PTs attempting again to get it added to their scope to make it fully legal.
As of this moment only L.Acs who graduated from an accredited acupuncture school, pass 3-4 state board exams, and MDs who took a 200 hour Medical Acupuncture course can legally get licensed by the PA medical board to practice in PA. However, it varies from state to state. PTs and Chiropractors are able to practice in some other states.
In addition to PTs, some Athletic Trainers are also doing Dry needling which is even worse. At this moment, it is still unclear who was working on TJ Watt when he got injured, but based on the use of the term, discussion about the PT association's definition of dry needling in the media, and comments made in the NYT and ESPN by fellow player Patrick Queen, it all really points to a PT or trainer.
Patrick Queen from ESPN:
Steelers inside linebacker Patrick Queen said he prefers to utilize acupuncture.
"Kind of two different things," Queen said of the practices. "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.
"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."
Queen said the extra education required to administer acupuncture is why he uses it.
"I just feel, me personally, more comfortable with somebody has a little bit more experience," Queen said. "Not saying anything wrong about anybody that did it or whatever, but that's just me personally."
Yes, it's frustrating from a professional standpoint to have other professions encroaching on doing acupuncture and often disparaging it as "Weird Chinese S**t" in the same breath, but for most of us, the top concern is public safety. We've been fighting to educate the public for years on this issue. We've been advocating for at least having other fields stick to their scope of practice and have a lot more training if they do get legally permitted to do this technique.
As a Steelers fan, it's devasting to see any of the team members go out with any type of injury, but what happened to TJ Watt is doubly upsetting, especially if done by an inexperienced or unqualified provider.
With that said, Pneumothorax is a risk from any form of acupuncture, though it's extremely rare. Rarer yet on someone as big and covered in muscle as TJ. Doing any type of needling on the upper chest, between ribs, even as high up as the traps and top of the shoulder need to be done with the utmost care, proper angle, and proper depth.
I hope this provided some info and insight. I hope Watt heals and is back to kicking butt soon!
