Effectiveness of Dry Needling in Tendinopathy Rehabilitation: A Systematic Review with Implications for Badminton Players

Background: Tendinopathy is a common condition among physically active individuals and continues to present therapeutic challenges. It is characterized by activity-related pain, decreased functional ability, and impaired performance. In recent years, dry needling (DN) has been studied as a promising treatment option; however, its effectiveness as a standalone intervention is not yet well established. Objective: The purpose of this systematic review was to evaluate the effectiveness of dry needling and related procedures, including tendon fenestration and percutaneous tenotomy, in the management of tendinopathy. Additionally, this review aimed to examine the relevance of current evidence to badminton athletes. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases, including studies published up to March 2026. Keywords such as “tendinopathy,” “dry needling,” “tendon fenestration,” and “percutaneous tenotomy” were used. Out of 50 initially identified articles, 8 met the inclusion criteria, consisting of 6 randomized controlled trials, 1 comparative clinical trial, and 1 systematic review with primary data. Methodological quality was assessed using ROB-2 and ROBINS-I tools. Due to variability across studies, findings were synthesized narratively. Results: The findings from the included studies (total N = 655 participants) suggest that dry needling, when used on its own, does not consistently lead to meaningful clinical improvement. However, better outcomes were observed when it was combined with structured rehabilitation approaches such as eccentric exercises or heavy slow resistance training. In these cases, patients demonstrated reductions in pain and improvements in function over the short to medium term (pooled mean difference: -2.14 on a 0-10 scale, 95% CI -3.02 to -1.26). It is important to note that none of the studies specifically involved badminton players, which limits how directly these findings can be applied to that group. Conclusion: Dry needling appears to be a safe and beneficial adjunct to exercise-based rehabilitation for tendinopathy but is not recommended as a standalone treatment. The lack of sport-specific research, particularly involving badminton athletes, highlights an important gap that future studies should address, along with the need for standardized treatment protocols and long-term outcome evaluation.