Clinical Forest Therapy in Orthopedics and Multimodal Pain Management

Medicine, Nature and New Approaches in Rehabilitation

Modern medicine offers highly developed diagnostic and therapeutic options. In orthopedic rehabilitation and multimodal pain management, evidence-informed treatment concepts, interdisciplinary collaboration and specialized therapeutic methods support effective recovery processes.

At the same time, it is increasingly clear that lasting health is not created in treatment rooms alone. Movement, body awareness, self-regulation and motivation often develop particularly well in natural environments. In this sense, nature can serve as a therapeutic setting that supports recovery and opens new pathways to physical activity, self-efficacy and health-promoting behavior.

Sana Kliniken Sommerfeld has taken up this perspective and is taking an innovative step forward with the Clinical Forest Therapy Trail for Orthopedics and Multimodal Pain Management Sommerfeld (KWTWS).

The Sommerfeld site combines medical and therapeutic expertise, rehabilitation experience and direct access to the forest in a unique way. This makes it an ideal place to integrate Clinical Forest Therapy into therapeutic care.

The KWTWS provides a structured framework in which nature-based interventions are linked with existing treatment approaches. The focus is not on the nature experience alone, but on the therapeutic use of the forest within the clinical context of orthopedic rehabilitation and multimodal pain management.



With this project, Sommerfeld has created a pioneering model: the first Clinical Forest Therapy Trail of this kind in Germany and, to our knowledge, one of the first in Europe to be integrated into a clinical care setting and professionally audited and certified under the IWSI/INFOM quality framework.

Promoting Mobility, Body Awareness and Self-Efficacy

The KWTWS helps patients experience movement as positive and safe again. The natural environment offers varied sensory stimuli and natural spatial cues that support movement, balance and coordination. Different ground surfaces, open spaces and natural orientation points can be used for structured exercises and sensory awareness activities. This can strengthen confidence in one’s own body and support active participation in the therapeutic process.

Reducing Pain Focus and Supporting Adaptive Regulation

The forest provides a setting that supports regulation. Natural sounds, changing light conditions and quiet, open surroundings can help patients broaden their attention and reduce a persistent focus on pain. At the same time, the forest offers opportunities for sensory awareness, presence and direct experience of the surrounding environment. In combination with structured sensory and movement exercises, this can support adaptive regulation processes and help patients develop a more flexible way of dealing with pain and related limitations.

Strengthening Everyday Transfer: Motivation and Access to Nature

Forests and natural environments are accessible spaces that patients can continue to use during and after treatment. Positive experiences in nature can strengthen motivation to engage in health-promoting behavior and integrate supportive routines into everyday life. In this way, the KWTWS supports the transfer of therapeutic strategies beyond the clinic stay and provides practical guidance for daily life. This can help extend the benefits of treatment beyond the clinic stay and strengthen patients’ self-efficacy.

The Green Prescription: Bringing Health Impulses into Everyday Life

IM-WALD-SEIN® THE GREEN PRESCRIPTION adapts a familiar German healthcare concept to Clinical Forest Therapy. Traditionally, a “Green Prescription” refers to a physician’s recommendation for over-the-counter health products. Within the IM-WALD-SEIN® framework, this principle is transferred to forest- and nature-based health activities.

At Sana Kliniken Sommerfeld, this approach is being implemented for the first time in an inpatient and day-clinic setting. It combines physician- and therapist-guided recommendations, simple forest therapy instructions for independent use and a structured follow-up process. The aim is to support initiative, self-efficacy and the long-term transfer of health-promoting routines into everyday life.

Perspectives on the Clinical Forest Therapy Trail Sommerfeld

Matthias Kloß, Managing Director of Sana Kliniken Sommerfeld:
“In healthcare, innovation means building on proven medical expertise while responsibly integrating new approaches into patient care. The Clinical Forest Therapy Trail Sommerfeld shows how modern rehabilitation, pain management and nature-based health services can be meaningfully combined.”

Dr. Volker Liefring, Chief Physician at Sana Kliniken Sommerfeld:
“The clinic’s own forest grounds have a long tradition in Sommerfeld. With the KWTWS, we are developing this approach systematically and integrating forests and nature into our orthopedic rehabilitation and pain management concepts. We are especially pleased that, as a training site of the IM-WALD-SEIN® Academy (IWSA), we can contribute to establishing a sound basis for Clinical Forest Therapy.”

Dr. Melanie H. Adamek, Director of the IM-WALD-SEIN® Institute:
“With the KWTWS, we show how nature-based therapies can be integrated into clinical care within a quality-assured framework. The forest is deliberately included as a therapeutic resource in established treatment concepts. At the same time, the KWTWS creates the basis for recommending nature-based health services through the original IM-WALD-SEIN® concept of The Green Prescription.”

Dieter H. Begel, Director of the IM-WALD-SEIN® Academy:
“The KWTWS creates a practical, standardized and transferable model for clinics. Our aim is to provide clinics with the skills and structures they need to integrate nature-based therapies into everyday care safely, sustainably and within a quality-assured framework.”

Sabine Oberg, Clinical Forest Therapy Instructor at the IM-WALD-SEIN® Academy:
“What matters is that Clinical Forest Therapy is not only understood conceptually, but implemented safely, in a patient-centered way and with a clear focus on the relevant indication in everyday therapeutic practice. Team qualification is a key element in this process.”

Prof. Dr. Qing Li, President of the International Society of Nature and Forest Medicine (INFOM):
“The Clinical Forest Therapy Trail Sommerfeld is an important example of how the findings of forest medicine can be transferred into a clinical care setting. The combination of medical treatment, therapeutic guidance, nature experience and quality assurance shows the potential Clinical Forest Therapy can offer for prevention, rehabilitation and modern healthcare.”