Judy Hoiness, 77, held onto a railing at Therapeutic Associates’ clinic one recent morning and stretched out her right knee by grabbing her ankle and pulling it beneath her pelvis. Nearby, a dozen middle-aged and senior men and women bent and twisted, some stretching out their backs with foam rollers. As recommended by a doctor, Hoiness has been visiting various physical therapy clinics on and off for the past 15 years due to chronic pain in her shoulders and back.

“Artists can get injuries that are pretty severe,” said Hoiness, a Bend resident and painter.

Each morning Hoiness joins the impromptu workout and stretching group that unfurls yoga mats on the carpet on the clinic’s second-floor landing of the Athletic Club of Bend. Hoiness returns to the daily stretching session to ward off pain as much as she does to catch up with fellow patients she knows.

“It’s a really social but dedicated place,” Hoiness said of the Therapeutic Associates clinic. The Bend location is one of about 70 Therapeutic Associates locations in the Northwest. About six or so offer the clublike inclusiveness found at the Therapeutic Associates location at the athletic club, a spokesperson said. Those half dozen locations similarly benefit from a partnering business’s amenities, which may include a restaurant, cafe and swimming pools and saunas, for example.

Laura Cooper, the clinic’s director of physical therapy, wants it to be warm and inviting — a world removed from a traditional clinic setting, which she says can be “a little bit more cold, sterile and impersonal.”

Building community among physical therapy patients and creating a more inviting atmosphere for patients is a growing emphasis among some of Central Oregon’s clinics. Local therapists believe going through rehabilitation with fellow patients leads to a faster, more effective recovery.

Focus Physical Therapy owner Burke Selbst said his clinic partners with Recharge Sport, an athletic recovery lounge that offers luxe amenities and a mostly open floor plan that allows for lots of commingling and camaraderie among clients.

“It’s a very diverse population — folks who go to physical therapy might be 12 years old or 92 years old. Creating a space that speaks to that breadth of people hasn’t been that common. It’s been really cool.”

Selbst emphasizes that the social aspect is an option, not a requirement, however.

“For those who want it, it’s great and better than without,” he said. “But having an option to stay one-on-one is also necessary.”

Renee Metivier, a professional runner who opened Recharge Sport in 2013, describes her hybrid studio, which also offers kombucha, CBD drinks and beer on tap, as place where coaches and therapists work together in a “very synergistic and social environment.”

To foster a warm and inviting vibe at Therapeutic Associates, Cooper has hung 20 of Hoiness’ colorful landscape abstractions in the halls and treatment rooms. It’s a cue Cooper borrowed from coffee shops.

“I think if you create that culture and environment that is fulfilling — not just in getting back your shoulder’s range of motion after a surgery — it’s creating a bit of community as well,” Cooper said.

Expensive treatment option

For Bend resident and cyclist Dennis Bennett, 49, 2015 was a rough year. Within a summer of bike racing, Bennett crashed and shattered his collar bone and spirally fractured his tibia and fibula. After surgeries to repair both injuries, Bennett sought treatment at Focus Physical Therapy. Previously, he had paid out of pocket to sit in one of Recharge Sport’s leather couches while a compression system (think inflatable leggings) accelerated his legs’ natural waste-flushing process.

To rehabilitate Bennett’s leg, which is now supported with metal plates, his therapist worked with him in the Recharge Sport area, which features a black-and-red motif and flat-screen TVs that often stream bike and running races.

Using Recharge Sport equipment, the therapist ran Bennett through lots of stretches to return his tendons and muscles to their former condition and to break up scar tissue. Bennett hoped to use some of Recharge Sport’s main services to speed up his recovery process, such as massage, acupuncture and personal training, but his health insurance didn’t cover them and he wasn’t willing to pay out of pocket, he said.

Burke Selbst, the owner of Focus Physical Therapy, said he sees physical therapy clinics increasingly offer more recovery services, which made partnering with Recharge Sport attractive. However, he’s aware that health insurance companies may not cover the bells and whistles that Recharge Sport offers.

“The financial system that is in place for traditional rehab is very different from the financial climate for people who use massage therapy and other cash-based services,” Selbst said.

Even if Focus patients can’t afford or choose not to pay extra for recovery services, Selbst likes that they still benefit socially during therapy sessions with Focus therapists conduct in Recharge Sport’s open space. And the chatty vibe heightens accountability from training partners, friends and coaches, Metivier said. Patients want to show up.

“I don’t know of any other clinic that has created the community that Recharge has,” said Selbst, who added that good communication between various service providers is vital in such a setting. “It certainly is what Central Oregon wants.”

An open approach

Some Bend athletes don’t mind a more spartan approach to physical therapy so long as the treatment is custom-made. Kevin Schaffer, 50, was referred to the recently opened Redbird Physio in 2015 after undergoing surgery for a broken femur and knee damage, which was the result of a helicopter skiing accident. Redbird Physio owner Andrew Fecteau, who previously co-founded Rebound Physical Therapy, had yet to fill the mostly open-floor studio with the equipment it now houses. Still, Schaffer said his physical therapist, Denny Dragan, who is also a Redbird Physio partner, was ready from day one with a treatment program he’d customized to Schaffer’s particular condition. If Schaffer was in pain, Dragan would devote one of his then thrice-weekly sessions to deep tissue massage. His treatment involved a lot of work with resistance bands and exercises like walking backwards on a treadmill.

Schaffer, whose knee has fully recovered, enjoyed Redbird Physio’s open-floor plan, which allows for socializing between patients at varying stages of rehabilitation.

“When you’re in one of those situations where not everyone understands the pain you’re in and there is also someone there in the same situation, sometimes you can reverb off that and it’s comforting,” Schaffer said. “… Even just a general conversation of ‘We’re going to get through this’ really helps.”

Fecteau is hesitant to describe a general culture at Redbird Physio because each physical therapist there is autonomous, which means each therapist may approach a situation differently.

“We’re very hands-on, manually based,” Fecteau said. “It’s all about a skilled PT being one-on-one with the patient. That’s the whole deal. You can do 80 percent with your hands and some bands and what you say (to the patient). … Like a lot of areas in health care and medicine, what you get good at when you’ve done it long enough is you get good at the basics.”

Understanding the pain

When Bend resident Howard Koff, 70, comes in for a session at Rebound Physical Therapy to rehabilitate his knee after a recent joint replacement, don’t offer the native New Yorker a kombucha.

“If I had been going to a physical therapist who was pouring me kombucha and the rest of the fluff, I would have left immediately because that’s not me,” Koff said.

What Koff does appreciate is getting down to business in the sessions he has with Rebound therapist Nick Hagen alongside other patients and athletes working out in the open floor plan of Boss Sports Performance, which partners with Rebound. There are 10 Rebound locations throughout Central Oregon. Boss Sports Performance, which retired professional football player Kevin Boss founded in 2014, is located in southeast Bend.

“I’m walking today like you wouldn’t even be able to tell I had these surgeries,” Koff said.

Koff, a limited partner in the Chicago White Sox since 1981, knows his way around the country’s best physical therapy, he said. After he initially blew out his knee playing baseball 15 years ago, Koff rehabilitated it with White Sox staff therapists at the team’s spring training facility in Arizona, he said. He liked rehabilitating while professional ballplayers trained alongside him. He found a similar environment with his Rebound sessions at Boss Sports Performance.

“When I look at the capability and the professionalism at Rebound,” Koff said, “it’s at that same high level.”

— Reporter: 541-617-7816, pmadsen@bendbulletin.com