The Joys of Foam-Rolling: An Interview with Dr. Kate Cleveland on Intramuscular Manual Therapy

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As I lay on my back staring at the imperfections in my living room ceiling, enjoying a moment of muscle pain relief afforded me by my foam roller, I am reminded that it wasn’t always this way.

In the past, the day following a set of particularly heavy dead lifts or leg curls would be followed by the inevitable soreness that no stretch could seem to quell.  The best I could hope for was a hot shower and frequent breaks from the desk to get up and stretch, twist, bend… anything to relieve the stiffness and pain.  THEN I was introduced to the joys of foam-rolling (insert angelic singing and cloud opening).

For me now foam rolling spells relief like Rolaids. It’s absolutely necessary, though when I first started out it was actually PAINFUL!  I recall my first attempts with the practice being nothing short of torture, as I rolled my unsuspecting muscles, wincing with every pass.  It can be a big deterrent in the beginning, but as I found out the more it hurts the more we need it!

Since I’m such a huge fan of foam rolling and see it as an integral part to the journey I took to improve my lifestyle and reduce excess body fat, I wanted to learn more about it. I did what I always do; I called an expert!  In this case I spoke with Dr. Kate Cleveland, PT, DPT.

kate2 Dr. Cleveland is a Physical Therapist at Grady Memorial Hospital, a Level 1 Trauma Hospital in Atlanta, GA. She specialize in treating acute orthopedic-trauma patients.

Kate, Where and what did you study?
I studied Biology and Chemistry at Mercer University in Macon, Georgia, and Physical Therapy at Emory University in Atlanta GA.

Do you workout? If so what do you like to do?

YES! I am a proud gym JUNKIE.
Variety is key. I enjoy strength training by lifting weights, balancing my mind and body with yoga, and elongating my muscles with Pilates. I also throw in Kickboxing and swimming and cycling for stress relief!

Do you live by any specific dietary rules? Vegan, Vegetarian, etc.

I am a Pescetarian; a diet that includes vegetables, fruit, nuts, grains and beans, eggs and dairy, and, unlike a vegetarian diet, fish, and sometimes shellfish. I occasionally eat chicken, which I guess makes me a Pollo-Pescetarian (if that even exits) 🙂

What is Intramuscular Manual Therapy / Trigger Point Release?

IMT is also known as trigger point dry needling. It is a minimally invasive procedure in which a sterile solid filament needle (acupuncture needle) is inserted into the skin and muscle directly at a trigger point. Trigger points are described as hyper irritable spots in skeletal muscle that are associated with palpable nodules or taut bands of muscle fibers. Physical therapists believe that these nodules are small contraction knots and a common contributor to the pain cycle. Compression of a trigger point may elicit local tenderness, referred pain or local twitch response.

IMT can be used for a wide variety of musculoskeletal problems with conditions including: neck, back, and shoulder pain, headache, buttock pain and leg pain. The twitch response triggers a brief painful twitch which some describe as an electric shock or cramping sensation.

Kate's E4A Progress

Kate’s E4A Progress

What is Myofascial Release and why should we be doing it?

Myofascial Release is a technique that provides sustained pressure by a physical therapist into myofascial restrictions to eliminate pain and restore motion. Self-myofascial release can be performed with the use of a FOAM ROLLER.

In the normal healthy state, the fascia is relaxed and wavy in configuration. It has the ability to stretch and move without restriction. When an individual experiences trauma, scarring, or inflammation the fascia loses its pliability. It becomes restricted and a source of tension to the rest of the body.

Myofascial Release treatments result in decreased pain and restriction, and increased flexibility and movement. Posture can be improved resulting in the elimination of some of perpetuating factors of recurring and or chronic pain resulting in longer periods without symptoms.

What are the benefits?

According to the National Academy of Sports Medicine, the major benefits of SMR are correction of muscle imbalance; improved joint range of motion, muscle length and brain-body awareness; decreased muscle soreness; and joint stress relief.

Can you describe an easy start up technique for people who have never been exposed. How should they start?

First-time users may only be capable of short sessions with minimal pressure, but just like building muscle or endurance, regular practice is necessary for optimal results. Start by identifying tender areas by rolling the foam roller under each muscle group. Once a tender area is found, stop rolling and maintain direct pressure for 30-60 seconds. Repeat this process daily in order to decrease tender trigger points and increase flexibility.
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One Last point on foam rolling. When you grab yours avoid the convenience of buying one or the lower end types often found on the shelves of major retailers. They start off firm and end up squishy in no time. You want FIRM, so go for a core foam roller or one with a PVC center such as the travel roller.

Beginner foam roller available here:


Intermediate level foam rollers available here:


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