A veteran physical therapist, Barrett Ford recently treated a patient suffering from back pain, a condition that was keeping her from her favorite activity. And as treatments were winding down and her body began to heal, Ford still noticed a level of trepidation in the patient – a feeling of uncertainty that her efforts inside the clinic would transfer into real life.

“Her biggest goal is that she wanted to get back to bowling, something she’s done for years,” said Ford, founder and co-owner of Step & Spine Physical Therapy in Bend, Redmond, and Sisters. “And for me to mention that’s where we can go – that we can go to the bowling alley as part of her therapy … to see how excited she was to do that was pretty amazing.”

Carol-Ann Nelson, DPT, founder and executive director of the nonprofit Destination Rehab in Bend

The reason Ford was able to offer this to his patient is because Step & Spine Physical Therapy recently teamed up with physical therapist Carol-Ann Nelson, DPT, founder and executive director of the nonprofit Destination Rehab in Bend. By working with the team at Step & Spine Physical Therapy, Nelson is able to provide the clinic’s patients an ancillary “outing and adventure” rehab services that added confidence – even joy – in the rehabilitation process.

“Our overall mission and goal is to improve confidence, independence and quality of life through community based outings and adventures, using a physical therapy and rehabilitation focus,” Nelson said. “We exist to reduce barriers to help people more fully participate in whatever community activities they want to do.”

Nelson works with people both in group and one-on-one sessions to address limitations and barriers that keep them from experiencing the joy of movement, activities and adventures. She is also experienced in working with individuals who have neurological conditions such as stroke, Parkinson’s, Multiple Sclerosis and spinal cord injury. What separates her from your typical physical therapist, however, is that Nelson does this outside the clinic – in the real world.

“I can work with each client in a new and changing environment. We work toward their goals outside of the clinic walls, and it gives me the opportunity to address specific barriers and challenges in real time,” she said. “When we are out in the community for a therapy session — walking the river trail, getting in a kayak, or out on the pickleball court — it’s a much more dynamic environment.”

Ford agrees.

“We’re completely excited to have a therapist that goes out in the community – at the shore, on the kayak, in the bowling alley, on the hiking trail – and addresses specifically what patients want to do,” he said. “It’s an amazing service she provides.”

Working with Step & Spine Physical Therapy allows Nelson to accept insurance from many patients, she said, and it also provides her with a base clinic from which she can work. Such partnerships are important, she added, as she continues to grow the community programing of Destination Rehab.

“Step & Spine Physical Therapy has been awesome to work with and super supportive,” Nelson said. “I bring an idea to Barrett, and he says, ‘Sure, let’s do it!’”

For more information about Destination Rehab and its events, camps, group sessions and individual rehab options, visit