active+ Karlsruhe

The practice

active+ is a physiotherapy and occupational therapy practice in Karlsruhe, run by two brothers, Jacob and Nicholas Bertram. They hold a 4.9 rating from more than sixty Google reviews, which tells you the treatment was never the problem.

Two problems at the same time

Jacob got in touch in June 2026 with two things happening at once. The therapists’ schedules had gaps in them that were not filling, and in a practice that bills by the appointment an empty slot is money walking out of the door. At the same time they were opening a second practice, an occupational therapy clinic, with no website and no way for a patient to find it.

A new clinic with no web presence does not quietly tick over until someone gets round to it. It just sits empty. Both problems needed solving quickly.

The Google Ads side

For the physiotherapy practice we built a landing page around back and neck pain, which is what people in Karlsruhe search for when they need a physio, and pointed a German-language Google Ads campaign at it.

German advertising law is stricter than ours on anything health related. The Heilmittelwerbegesetz governs how a clinic may advertise, so every headline and description was written to stay the right side of it: no promises about outcomes, no medical claims, plain factual description of what the practice does. Nicholas read every line of German before it went live and sent back changes, which we applied. We took out a service they do not offer, added a weekday caveat to the reply-time line so it promised nothing at a weekend, and corrected the opening hours.

Conversion tracking was wired end to end so phone taps, email clicks and form submissions all report back, and a Looker Studio report goes to Jacob on a schedule. It leads with enquiries rather than clicks, because clicks are not what a physiotherapy practice is buying.

The new website

For the occupational therapy clinic we built ergokarlsruhe.com from scratch. Eight pages covering treatments, the team, jobs and booking, with structured data so Google reads it as a clinic in Karlsruhe rather than a brochure. The homepage finishes loading in just over half a second.

We also built a German and English toggle into it, which nobody had asked for. Karlsruhe has a large international population, and a practice that can be read in English is a practice more of those people will book with. Jacob and Nicholas found it in the first draft.

What changed

This part is better in their words than ours. On the advertising: “They also ran a new and updated Google Ads campaign with regular reporting so we could see what was working. The results are an increase in enquiries, both by phone and contact form. And this really helped us fill the gaps in the schedules.”

On the website: “We now have a very fast working and professional website tailored exactly to our needs, and a strong web representation and presentation for patients and future hires.”

The full recording and transcript are below.

The takeaway

Two problems that looked like one job. A practice with empty diary slots needs demand, and a practice that does not exist online yet needs to exist. Those are different pieces of work and they were solved with different tools, advertising for one and a website for the other, on the same retainer and at the same time.

Working across a border and a language was the part we expected to be hard. It was not, because the client read his own copy and told us what was wrong with it.