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Rehabilitation

How Physical Therapy and PSSE Can Change Life with Scoliosis

Maggie stands tall and stretches a band as she works with Gillette physical therapist, Michelle Enberg in the PT room.

Maggie works with Gillette physical therapist, Michelle Enberg, who is specially trained in physical therapy scoliosis specific exercise (PSSE).

Gillette Children’s is proud to offer physical therapy scoliosis specific exercise (PSSE) to help patients reduce the symptoms of scoliosis—which is a curvature of the spine.

Two Gillette physical therapists, Michelle Engberg and Katie Wilkins, have undergone extensive training to become experts in PSSE.

“The goal of our exercises is to de-rotate, elongate and stabilize the spine in a three-dimensional plane,” Katie Wilkins, PT, says. “Every exercise we do with a patient is aimed at setting them up for best positioning. This PSSE therapy can help with things like an elevated shoulder, a trunk that is slightly shifted, or issues with the hip,” Wilkins adds.

Maggie Anderson sits with her mother and PT Michelle Engberg to look at her spine images on a laptop computer.

Maggie Anderson and her mother appreciate the care from the Gillette physical therapy team and the Spine Institute.

Imaging, bracing, surgery, and physical therapy are part of Gillette's scoliosis care options

Maggie’s journey with scoliosis began during a routine physical in 2019. Her pediatrician suggested she get a scoliosis evaluation at Gillette because she saw a slight curve in Maggie’s spine—which is an indication of scoliosis.

The Gillette Children’s Spine Institute is known for its extensive research and its commitment to providing multidisciplinary, personalized spine care options.

The first part of a scoliosis referral at Gillette includes imaging so the expert team can see what kind of curve the person has and the degree of curvature. On an x-ray, the spine of a person who has scoliosis looks like an “S” or “C” curve instead of a straight line. Providers use a special tool to measure the angle of the curve, called a Cobb angle. In Maggie’s case, she had four curves in her spine, which is unusual.

“When I first saw that x-ray of my spine I was flabbergasted. To me, my spine looked really messed up,” Maggie recalls.

“My mother and I got a lot of information at that first appointment at Gillette. To be honest, I was a little overwhelmed,” Maggie says. “I was fitted for a brace that same day and the team told me about various options to treat my scoliosis.”

At the time, Maggie played volleyball in school and was very committed to athletics. She and her mother were concerned her scoliosis diagnosis would have an impact on Maggie’s athletic activity.

Maggie was determined to do everything she needed to do to keep active. She reports she wore her back brace as often as she could and jumped at the chance to work with the Gillette physical therapy experts to strengthen her muscles and improve her chances of stopping her spinal curve from progressing.

Gillette PT Michelle Enberg shows Maggie some spine strengthening exercises on the mat.

“One of the benefits of getting PSSE and working with a physical therapist is that we can help improve the flexibility of the spines that are stiff,” Michelle Engberg, PT, says.

Specialists in Physical Therapy Scoliosis Specific Exercise (PSSE)

Gillette is proud to offer physical therapy scoliosis specific exercise (PSSE) to help patients reduce the symptoms of scoliosis and, possibly, it keeps the curvature of the spine from getting larger.

The two Gillette physical therapists Maggie worked with, Michelle Engberg and Katie Wilkins, have undergone extensive training to become experts in PSSE.

“One of the benefits of getting PSSE and working with a physical therapist is that we can help improve the flexibility of the spines that are stiff,” Michelle Engberg, PT, says. “This can help with posture and make bracing easier. For spines that are already flexible, PSSE can strengthen and teach stabilization in the best position possible for that spine."

Experts from the Gillette Spine Institute can determine if PSSE is an appropriate treatment for patients who are 10 years of age and older, have adolescent idiopathic scoliosis and have a spinal curve approximately 20 degrees or greater.

Gillette PT Michelle Enberg helps Maggie by suggesting some exercises to help with neck pain.

Gillette PT Michelle Enberg helps Maggie by suggesting some exercises to help with neck pain.

Physical therapy and the Gillette orthotics team make scoliosis bracing easier

Both Engberg and Wilkins say PSSE helps people achieve a stronger, more flexible spine. They add if Gillette experts suggest bracing for a scoliosis patient, gaining more spine flexibility can make the bracing easier and more comfortable.

Scoliosis patients at Gillette have the benefit of having their braces created in-house by  a spine bracing expert in the Orthotics, Prosthetics and Seating (OPS) department. After a spine evaluation appointment and a fitting appointment, the OPS team may work with the physical therapy team to make sure the customized brace is comfortable for patients and is helping to curb the progression of a spinal curve.

Engberg and Wilkins say the PT and OPS team at Gillette are very experienced and highly trained to help people feel the best they can while wearing the brace and doing their exercises.

“One of the main goals of doing physical therapy for scoliosis,” Engberg says, “would be to keep the curve from getting worse or progressing in kids that still have growing left to do."

Maggie works with Gillette PT Michelle Enberg on the therapy ladder.

Gillette physical therapy experts work with Maggie to strengthen her muscles and improve her chances of stopping her spinal curve from progressing.

PSSE brings spinal surve improvements and a career decision

The hard work and dedication to PSSE paid off for Maggie. During a 2021 appointment with Gillette spine surgeon, Joseph Perra, MD, it was determined that the degree of her spinal curves actually decreased.

“It really was a miracle!” Maggie exclaims. “When Dr. Perra told me my spine curve was improving I felt incredible gratitude to my physical therapy team. I was proud my commitment to PSSE meant my core strength was better. Honestly, it made me feel empowered.”

Maggie was so inspired by the results of her physical therapy journey that she’s studying to become a physical therapist herself. “My physical therapists, Michelle and Katie, helped me become mentally and physical stronger. They both really mentored me and inspired me to become a PT.”

Maggie says being diagnosed with scoliosis and her spine care journey at Gillette “really changed the trajectory of my life.” She adds, “I look forward to sharing my life-changing journey with scoliosis and to helping other people learn how they can help their body heal and live a good life.”

Gillette Children's Spine Institute

Since Gillette Children's opened in 1897, complex spine care has been a focus of our journey. Our Spine Institute has a rich legacy of excellence, innovation, and listening to patient goals. We offer comprehensive, personalized care for children facing complex or everyday spine challenges.

Gillette is conducting research into many spine conditions to improve care and outcomes for patients. A new research project led by pediatric spine surgeon and chair of the Gillette Spine Institute, Tenner Guillaume, MD, is an observational study that follows people with spondylolysis/spondylolisthesis who are undergoing observation for bracing for their condition. People interested in participating in this research can read more on the Gillette research site.