To complement the MASSAGE Magazine article, “Gaga Over Heels: Myoskeletal Alignment,” by Erik Dalton, in the September 2011 issue. Article summary: Last week while flipping TV channels, I happened to catch some interesting gossip from a cheesy entertainment show reporting that Stefani Germanotta, aka Lady Gaga, was being treated for low-back pain at a local physical therapy clinic. This uniquely talented, five-time Grammy Award winner and self- proclaimed “high-heeled queen of sheen” has probably done more to mess up low backs than anyone since Mike Tyson. So, here she is at the ripe age of 25 suffering back spasm.

by Erik Dalton

How does one fix the foibles of fashion? We must educate our clients to the pitfalls of high heels; offer home-retraining exercises, where this is allowed within a massage therapist’s scope of practice; and discourage this harmful addiction. But what if common sense fails? Should we accommodate this self-destructive behavior by developing a treatment plan while knowing its uselessness in the long term?

Perhaps some manual and functional movement methods provide temporary relief from high-heeled distress symptoms, but these modest gains will ultimately be ineffective in re-establishing natural gait. Studies consistently demonstrate that natural gait is biomechanically impossible for any shoe-wearing person. Until the client agrees to reduce the number of hours in heels, stubborn musculo-fascial imbalance patterns will persist.

The shoe’s elevated heel will continue to shorten the Achilles and tighten calf muscles causing tentacles of strain—such as plantar fasciitis, shin splints, bunions and knee, hip and low-back pain—to infiltrate all systems of the body starting with the feet. Stretching, strengthening, joint mobilization, structural integration and functional movement training are all effective tools for re-establishing proprioception, motor control and relieving pain from damage done, but only if the client first can resolve her high-heeled fashion addiction.

A few of my favorite joint-stretching and Myoskeletal Alignment routines for mobilizing foot fixations and accompanying fascial compartmental syndromes are pictured in the September issue of MASSAGE Magazine. Add these to your touch-therapy repertoire along with appropriate whole-body biomechanical assessments. To correct for length-strength imbalances and to restore proper motor control patterns, I recommend working in conjunction with a good functional movement therapist.

In compiling chapters for my upcoming book, Dynamic Body, I’ve been enlightened by some new and very exciting functional corrective strategies from illustrious contributing authors, including Judith Aston (Aston Kinetics™), Serge Gracovetsky (Spinal Engine®), Thomas Myers and Robert Schleip (Fascial Fitness™), and Craig Liebenson (Functional Performance Training™).

Find a good functional therapist who complements your hands-on work—or better yet, seek specialized certification training and deepen your existing skill-set.

Erik Dalton, Ph.D., created the Myoskeletal Alignment Techniques® and founded the Freedom From Pain Institute®. Dalton teaches to massage, sports, and pain-management therapists and offers top-selling home-study courses with Certified Myoskeletal Therapist certification. Visit to read previously published MASSAGE Magazine articles and to subscribe to free monthly technique e-newsletters.