Abdominal Therapy for Pelvic Pain and Infertility (Episode 315)

Full Transcript: Episode 315

Lisa: Welcome to the Fertility Friday Podcast, your source for information about the fertility awareness method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones.

I’m excited to share today’s episode with you. In today’s episode, we are talking about abdominal therapy for infertility and period pain, and for those of you who’ve been listening to the podcast for a while, you’ll know that this is a topic I’ve covered in a number of different episodes, covering a number of different modalities, but really focusing on that concept of physical, visceral manipulation of the abdominal area to increase circulation and to reduce or eliminate adhesions in a non-surgical fashion.

I’m really excited to welcome two guests to the show today, Belinda Wurn and Larry Wurn. Belinda is the Director of Services for Clear Passage Therapies. She graduated summa cum laude with a B.S. in physical therapy from the University of Florida, and with extensive postgraduate work and decades of professional experience, she’s considered an expert in the causes and treatment for various types of sexual dysfunction. Larry is the CEO of Clear Passage Therapies. He graduated from San Francisco State University with a B.S. in English and Creative Writing, and graduated from the Florida Institute of Natural Health in 1990 to become a Florida-licensed massage therapist. Together, Larry and Belinda have developed the Wurn Technique and Clear Passage Approach, a non-surgical treatment for chronic pain, female infertility, bowel obstruction, and sexual dysfunction. So without further ado, welcome to the show, Belinda and Larry.

Belinda & Larry: Thank you so much for having us.

Lisa: Well, thank you for being here. Maybe just share with us what inspired you to create the technique that you have, what inspired you to go into the realm of female fertility.

Belinda: Well, I’ve been a PT since 1975, and in ’84 I developed cervical cancer, and by the time they found it, it had spread toward my rectum, so they were scared to do a hysterectomy. The physicians were very aggressive with me with external and internal radiation, and it killed the cancer, and I’m still here at 68. But it basically destroyed my ovarian function and threw me into menopause at 33, and I developed what’s called a frozen pelvis, where all my organs were glued together from adhesions. I couldn’t work for about three years. I had complex pain, intestinal problems, pain sitting, pain with intercourse, sacrococcygeal pain, and I went to many different doctor specialists, and I got really tired of hearing “it’s all in your head” or “you have to learn to live with it,” and that wasn’t acceptable. So that started me on the path of studying any kind of manual, hands-on technique that I’d read about in the weekly PT publications, and anyone who could help me, I started studying what they did.

Larry: We were about to get married. I’ve known Belinda all my life, we were childhood sweethearts, and a year after all this radiation therapy and surgery she was in debilitating pain, since doctors said, “we can’t operate there, those are adhesions, which is a very sensitive area, and eventually we would just cause more adhesions and more problems.” So we started studying courses in the U.S., and also went to medical school in France for a while for some courses, to learn how to treat adhesions, because there really weren’t any therapies then to develop adhesions for treating the female reproductive organs. When we came back and we started getting Belinda out of pain, a year and a half later she was working 40, 50, 60 hours a week with no pain, when before she was in debilitating pain from adhesions. So we thought that was great, decided to treat some patients with pain, and were very surprised when a patient came in.

Belinda: So within our first years, we opened our first private practice in 1989, and in 1990 we were treating a woman who had a work-related slip-and-fall injury. We were treating her for headaches, neck, back, and tailbone pain, and she had had a myomectomy, a fibroid removed from her uterus, so she had the horizontal bikini incision, and it keloided, it was really thick and bumpy and lumpy, so she asked if we would treat her scar while we were treating the rest of her.

Lisa: Sorry to interrupt you, for the listeners who are not a physiotherapist, keloid, what does that mean?

Belinda: A keloid is a scar that heals very lumpy and bumpy instead of smooth. It sticks out, it’s thickened.

Lisa: And is it painful, or is it just not nice to look at?

Belinda: It’s not nice to look at, I don’t believe it’s painful. So of course we said yes, we would treat the scar, and we treated her in the pelvic area. She came in one day and said, “Belinda, you’re not going to believe what my doctor told me the other day.” I said, “what’s that?” And she said, “I’m pregnant.” I said, “that’s great, congratulations,” and she said, “wait, you don’t understand.” She had had the HSG dye test done seven years prior to our treatment, and she knew that both of her tubes were totally blocked, so she hadn’t bothered using birth control. So it was a big surprise, and she went on and had a baby boy. So it took several years to get to that point, but we realized we were opening blocked fallopian tubes. Physicians started referring patients to us with blocked fallopian tubes, some without, they were just infertile, and most of them were becoming pregnant, we were opening their tubes.

Larry: The chief of staff of the hospital called me in. He said, “Mr. Wurn, I’m a surgeon, I’ve been a surgeon for 30 years, gynecologist and researcher, what is this about opening blocked fallopian tubes?” I handed him a half a dozen charts and he said, “oh my god, you’re doing things with your hands I don’t think I can do surgically, and I’m a really good surgeon.” I said, “is that okay?” He said, “yeah, that’s really fascinating, are you doing any research?” I said, “no, would you like to?” He said, “sure, why don’t I be your research director, I won’t charge you anything, I just think this is important work, and we’ll start to develop some publications and see how useful it is for women.” So we started, and we’ve now published about a dozen publications.

In the most recent one, let me pull it up: here’s a nice shot of some fallopian tubes that we had treated, and fallopian tubes who ended up being easy to quantify, because women would come in, and as shown on the left here, you can see a little straw going into the uterus, that V-shaped area, the large white area is the inside of the uterus, and the dye goes no further than the little horns up there.

Lisa: So for the listeners, what you’re showing me is an image — so when a woman is having a fertility assessment, one of the tests the doctors would perform is the HSG, which involves essentially putting dye into the fallopian tubes to see if it can actually pass through. So what we’re seeing is an image of that?

Larry: That’s correct.

Lisa: Okay, this might be an image we can have on the show notes page so listeners can take a look through it. But essentially what you’re saying is you teamed up with a surgeon who became the director for your research, and since then you’ve been able to conduct peer-reviewed scientific studies that have been published to lend credence to what you were seeing in your practices, am I getting this correct?

Larry: Absolutely, yes. And I’ll just say one last thing, because in the beginning we were surprised, and we said, “how many do we need to treat to make sure this wasn’t a fluke,” and the biostatistician said six would be good, or eight. Well, the first publication we did on opening blocked fallopian tubes showed 28 women in it, and we opened totally blocked tubes in 61% of them. In our latest publication, we’ve just had our thousandth baby born from Clear Passage.

Lisa: Well, could we talk a little bit about what is happening here? For my listeners, especially those who’ve been tuning in for a few years, I’ve interviewed a number of practitioners of different modalities, ranging from Arvigo therapy to fertility massage therapy to Mercier therapy, which are all different but have similar threads — they involve specific treatments to the pelvic area to increase circulation and movement and to remove adhesions. Could you talk to us a little bit about the physical aspect of your therapy? Like, what if a woman were to come to you, what’s she in for?

Belinda: Sure. Ours is a 20-hour program, and it’s based on science. It’s one thing to be able to say we can do that and we can help, it’s another thing to go through the task of actually gathering clinical research, having studies designed by physicians and biostatisticians, and then developing and publishing results that pass peer-reviewed literature, so that it’s in the National Library of Medicine and the National Institutes of Health publishes it. I just wanted to set that in perspective. What we are doing, what we have always been doing, is treating adhesions. Adhesions are the internal scars that form whenever we heal — thousands of tiny strands of collagen, they’re very strong, like the strands of a nylon rope but short. They come rushing into any area where you’ve had an infection, a surgery, a trauma, or endometriosis, and they lay down and blanket the area, they become an internal scar.

Larry: We started studying these because it was vital to us to save Belinda’s life, or lifestyle, and we hired a double PhD to examine what it is we’re actually doing that’s opening these tubes, because we were just treating adhesions. We believe that what’s happening is where these strands are laying down, we are detaching them from each other, kind of like pulling apart the run in a sweater.

Lisa: And how are you doing that? Are you physically touching the abdomen, are you doing an internal procedure, what is the procedure?

Belinda: It is all using our hands. It is very specific — we palpate the abdomen and the pelvis, for women with infertility or endometriosis or any sort of pelvic pain, we feel for where the organs are adhered or the tissues are thickened, and we apply a stretch, and we hold the stretch for a prolonged period of time until the adhesions gradually start to detach and give way. So what we’re doing isn’t massage, we don’t use lotion, we need the friction under our hands against the adhered organs or tissues to get the adhesions to give way. It’s as if we’re very gradually peeling apart tissues and organs that are stuck together that shouldn’t be, and as the organs and tissues can move more freely, pain symptoms start to get better and go away, and the organs can function more normally. It’s like we’re slowly peeling this straightjacket off of them.

Lisa: This is really interesting to me, because I’m not a body worker, and I’m really fascinated by the idea that you can actually palpate the abdomen and, with your hands, identify where those adhesions are, based on your expertise and skill, and then physically work those, so you can actually feel where they are?

Belinda: Yeah, absolutely. We work externally, but we also work internally, vaginally, and it allows us to have a few glove fingers vaginally and our other hand externally, freeing adhesions up from the outside in, especially on scars, and from the inside out, if a woman’s had an abortion, any kind of a procedure to laser the cervix for cervical cancers, we can feel where things, the tissues or the organs, feel stuck or thickened or lumpy. After we treat people, especially if they have scars, the scars look and feel totally different, they look flatter and they’re not so stuck to the tissues and structures underneath.

Lisa: Is it something that you do in all cases, or is it case-by-case? And is it uncomfortable for the woman who’s having it done?

Belinda: Generally speaking, the physical therapists, they’re all female physical therapists that we have working for us, highly trained in our certification process, they’re pretty much all going to do an internal assessment at the beginning during the initial evaluation, unless the patient refuses. I don’t think anyone has ever refused it, because they want to get their goals met, and thereafter we will treat internally as much as is needed. When you realize you have an area that is warm, moist, and dark, perfect for life to grow, and women have objects coming into them from the outside world that may not always be sterile and clean, it’s a perfect place for bacteria to grow, so you can get vaginal infections, subclinical or clinical, and it’s a place that gets traumatized from time to time — rushed sex, abuse, athletic injuries, falls when you’re roller skating or a cheerleader — all of that can cause adhesions on the inside of the vagina and alongside the uterus and on the cervix, throughout the pelvic floor. Often it will cause pain either with initial penetration or with deep penetration when a partner is hitting that cervix or the coccyx, so we need to be there in order to get all the results that some women need.

Lisa: What’s interesting about the work you’re doing is the application, the different areas this can help — of course we’re talking about fertility, but you’ve also mentioned sexual dysfunction, improving orgasm, and bowel obstruction, so digestive issues too. Could we go back to the blocked tubes? As you know, when women have the HSG done and it comes back that their tubes are blocked, essentially the medical world says there’s nothing that can be done, and the only option is IVF. So it seemed as though in the first example you shared, Belinda, you weren’t setting out to unblock a woman’s tubes, you were treating someone completely different. Could you describe how addressing adhesions in other areas then has this impact on the fallopian tubes, and, in your controlled research, did you come across a more detailed explanation as to why this was happening, why the tubes were getting unblocked?

Larry: Tubes generally get blocked due to adhesions, and when the medical profession told us there’s nothing you can do to open blocked fallopian tubes, but we were opening them and women were having babies, the chief of staff at the hospital got really fascinated, and we started doing some studies. In the latest study we had 143 women whose tubes reopened out of 235, so it was a 61% success rate. The success rate was much higher if a woman had not had surgery on her tubes, because surgery does cause adhesions in that area, so the success rate’s about 69% if they’ve not had surgery on their tubes, and about half of that, about 35%, if she has had surgery on her tubes.

Lisa: And just to clarify, when you say surgery on her tubes, is that a surgical procedure to open the tubes?

Larry: That’s correct, and the results of having tubes surgically opened are not great. What we found, and studies show, is that if a woman has her tube surgically opened, she has a six-month window within which to get pregnant, and if she’s not pregnant within six months, the adhesions that form from that procedure itself block the tubes right back up.

Lisa: I feel like I just want to hang out there for one second, because I find that really interesting, that these are organs designed to carry a single cell. Can you describe the size for us?

Belinda: Yeah, they’re tiny, designed to carry a single egg, even though that egg may split into about eight cells by the time it’s fertilized. It’s about the size of a hair, and they’re about four inches long, so it’s tiny, and when you see an electromicroscopic image of the inside of fallopian tubes, they’re beautiful, they look like a lush underwater garden, a very vital organ, until they’re blocked with adhesions, and then they don’t look like the garden anymore.

Larry: The main things that block tubes — the most common cause is an infection or STD, chlamydia is one of the biggest causes, and you have this infection that may start in the vagina but it spreads into the cervix and then out into the uterus and out the tubes, and ends up blocking them. So the main four things that create adhesions are surgery, trauma of any sort, falls, car accidents, or infections or inflammatory conditions like endometriosis. Any of those things, or a combination, can cause tubes to get blocked.

Lisa: I appreciate you going through the reasons why, because it’s very common for tubes to be blocked, and for some women they may have had chlamydia or another STI and weren’t even aware they had it, they were asymptomatic, so it’s quite a devastating shock to learn later that your tubes were blocked from an infection you didn’t even know you had. Now, do you have a specific treatment protocol you follow when you’re targeting the blocked tubes, versus a more general approach to adhesions in the pelvic area?

Belinda: We can feel where we need to be. We have the patient’s history, we spend hours going over patients’ histories before we even accept them into the program, because we will accept a woman if we think we can help her, and if we don’t think we can help her, or there’s a problem such as a cyst that is too large, or an endometrioma we don’t want to burst, we would turn her down. We’ve developed techniques over the last three decades to specifically address fallopian tubes, and at the same time we’re addressing all the areas around the abdomen, pelvis, down into the leg, into the adductor.

Larry: We’ll work on the bladder, many women have bladder issues, stress urinary incontinence, we’ll work on different parts of the small intestine. You have to picture the pelvis and abdomen — there’s no space in between the organs, they’re all crammed in there, so adhesions that affect the uterus and tubes can spread and crimp or kink part of the small intestine, causing bowel obstructions, and can cause bladder problems. You have to picture this spider web of adhesions sticking to anything and everything in the vicinity, so we treat whatever we find has restricted mobility.

Lisa: Does your work extend to other conditions? I know when women have issues postpartum, like uterine prolapse, often surgical options are presented. Is that something you address?

Belinda: We do see many people who have prolapses, we’ve been able to help them somewhat. If it’s a severe prolapse, they may still require surgical intervention, but we encourage them to wait until they’ve healed for 12 weeks and then come see us, so the tissue doesn’t become as bound down by adhesions from the surgery. About a third of our practice is women with infertility issues due to different causes, about a third is complex chronic pain that people experience, men and women, and about a third is treating people with digestive and intestinal problems, bowel obstructions.

Lisa: And you mentioned sexual dysfunction as well — could you share how this treatment can improve sexual issues, what types of issues are women experiencing, and how the treatment helps?

Larry: Absolutely. We were surprised when a woman called Belinda about six weeks after treatment. She was 45 years old, and said, “has anybody ever reported anything unusual to you? It’s kind of embarrassing, but since I’ve come home I’m having orgasms like I’ve never had in my life, real toe-curlers, they were so unusual I had to report them to you.” This happened about six or eight times, and Belinda asked me what we should do about it. I said, “don’t even mention it, we’re already the weird practice in town.” But the chief of staff of the hospital said, “Larry, that’s really important, we need to research this,” because there is a way to measure the six domains of sexual function, and as gynecologists there’s very little that can be done — desensitizing agents, painkillers, or sending a woman to a psychiatrist. So we presented to the American Society for Reproductive Medicine, and had the abstract published in Fertility and Sterility, because we improved all six domains: desire, arousal, lubrication was a huge improvement, orgasm including first-time orgasms, satisfaction, and pain.

It began to show us that adhesions can form anywhere, they can form on the vaginal wall, decreasing desire, lubrication, and orgasm, and causing pain in some women — some women just the desire goes down, or the lubrication goes down. It was quite encouraging when we presented at that conference, and it was interesting that about 90% of the audience were psychiatrists, because they thought intercourse pain was all in a woman’s head, and of course that’s not where it is. We found that with almost all of our female patients who had some pain with intercourse, the cervix was very adhered. There are four ligaments that attach to the cervix, it’s the most fixed point in the female pelvis, and all of those ligaments need to be elastic, like stretching a rubber band. If any of the ligaments attached to the cervix are adhered, the cervix is not able to move out of the way during intercourse, so it hurts. But we found that by freeing up adhesions affecting the cervix and vaginal wall, pain with intercourse significantly decreased — we resolved it in about 90% of cases.

Lisa: And one of the questions I wanted to ask — what is the function that’s allowing this to happen, what’s physically improving a woman’s ability to orgasm and lubricate, and reducing the pain? One of the common threads in these types of discussions is that we consider the uterus dynamic. My area of specialization is menstrual cycle charting and fertility awareness, and one of the ways to identify where you are in your cycle is through checking the position of your cervix. Throughout your cycle, your uterus physically moves and the cervix points in different directions based on your hormone levels, so your uterus needs freedom of motion. What’s really interesting is addressing the physical aspect of orgasm by removing adhesions around the cervix so the uterus can freely move during sex — I think that’s really profound.

Larry: The uterus absolutely needs to be mobile. There are six ligaments that attach to the uterus — the broad ligaments run along both sides and attach to the pelvic bones, the round ligaments run from the front of the uterus through the groin and attach near the labia, and two uterosacral ligaments go from the back of the cervix to the coccyx. All six of those ligaments need to not be adhered, and in order to have an orgasm, the vaginal walls narrow and the uterus becomes more vertical and moves upward in the pelvis — if uterine mobility and the uterine walls are adhered, it’s harder, if not impossible, to have an orgasm.

Lisa: There’s something else I want to touch on — you mentioned in your conference how this relates to the idea that intercourse pain was thought to be emotional, when it can be related to a physical adhesion in the pelvic cavity. I think for a lot of women listening, especially those who may have experienced difficulty orgasming or low libido or pain with sex, this information is vital, so they understand it could be related to a physical issue, like any other health condition. Did you get any interesting feedback from the psychologists?

Larry: They were shocked to hear there was something going on other than it being all in a woman’s head. I got a lot of questions afterwards, some asking about opening blocked fallopian tubes, because the psychiatrists had been through med school, so they could understand there are mechanical attachments there, and yes, adhesions can form anywhere. So the dawn started to launch for them.

Lisa: This is really valuable, and I think the work you’re doing is incredible. A lot of the practitioners doing similar physical manipulation work don’t have access to the resources you’ve had, and don’t necessarily have the ability to produce studies to verify their results. What’s your vision for how this knowledge gets into mainstream medicine?

Larry: I think publishing studies is absolutely vital, and backing up for a second, it’s not that we had friends or that it was easy doing research — we had to go out and hire PhDs and physicians, and then hire a double PhD to do the work and a statistician. That capability is open to all these other modalities. I would encourage them to go out and hire some PhDs and find out what their actual percentage of success rate is, how they even measure the success, so they can say, “this is what we can do, this is what our studies have shown, this is what independent researchers have shown can work.” That’s available to anyone, it was a whale of a lot of work, takes a lot of time and energy, and we like to treat people, that’s why we don’t do the research ourselves, we hire people to do it.

Lisa: Would you mind hanging out there for a moment? I think what I hear a lot is that research would cost millions of dollars, and that a small organization doesn’t have the funds to put together these studies. What would you say to the person who says “I don’t have millions of dollars, how could I ever do research myself?”

Larry: We’re not a big corporation with millions of dollars either. There’s a scientific method where you start seeing results, you gather data, you keep your data, and then you can do a single case study, a single retrospective — this is interesting, this happened, it’s called anecdotal, but you can still publish that, it may cost a few hundred dollars to have it published. Then you can do a multiple case study, if you have before and after images or data, and if you can get 10 or 20 of those, you have a pretty good pilot study you can publish. It’s incumbent upon the practitioner to keep their data and start gathering it, and then write it up and submit it, or go to a place with medical writers — it may cost a thousand dollars to have the study written up by someone capable of doing it, and an extra thousand or fifteen hundred to have it published. Then you go on from retrospective to prospective studies, and then to controlled studies, so there’s a scientific method, and people should look up the scientific method, but they should start keeping their data and thinking about the case studies they can publish.

Lisa: Thank you for sharing that. What you basically described is starting where you’re at and finding a way to track your data — a couple thousand dollars might sound scary, but a couple thousand dollars is not a couple million. So what you described means it’s not unobtainable, it’s not impossible, to start small and gradually build over time.

Larry: Yes, you may be able to find a PhD who will write the study for free just to be named on it.

Lisa: We’ve gone into quite a bit of detail about how this physical procedure can impact fertility. Is there anything else you wanted to touch on, any other aspects of the treatment and how it relates to fertility, that you want the audience to know?

Belinda: We started out treating adhesions, and adhesions form anywhere in the body, including the female reproductive tract, and we’ve been able to track that this improves fertility in a number of ways — in women with endometriosis, PCOS, blocked fallopian tubes, and even hormonal infertility. We’ve been surprised with women who have been declared hormonally in menopause who have become pregnant, and become pregnant again, and we’ve published on that as well.

Larry: The fact that adhesions affect your fertility, they do not only affect the reproductive organs — they will pull you forward, so if you feel pulled forward, short, with a tight back and neck because it’s fighting all the time to get you up straight, getting those adhesions treated and released improves your general overall health and quality of life immensely, and we’ve measured range-of-motion improvements and published those as well. We weren’t really trying to open blocked fallopian tubes or improve sexual function, we were just trying to get people out of pain and decrease adhesions, and all of these things came from that. When you have a therapy that addresses adhesions effectively, the quality of life improvements can be profound, along with fertility, especially in women with significant surgical history or endometriosis.

Lisa: I feel like that really sums it up, and I want to thank you, Larry and Belinda, for coming on the show and sharing your expertise. I know a lot of listeners will head right over to the show notes page to look into your research and the studies you’ve published. One of the things I always say is that if a research study hasn’t been done on a particular protocol, it doesn’t automatically mean the protocol doesn’t work, it means the research hasn’t been done, so it’s really inspiring that you went out and did that research to lend credence to abdominal physical therapy modalities aimed at removing adhesions. As a coda, if someone is interested and wants to learn more, where should they go?

Larry: Our website is about 500 pages, full of information designed to inform a person, and if they feel it will help them, they can click a button and apply for therapy, and we’ll see if we can help them — that’s at clearpassage.com. We’ve also authored a few books, the most recent a consumer book called “Adhesions: The Body’s Hidden Menace,” available on Kindle, with a good section on fertility. If someone is interested, they can apply, we’ll go through their history, we don’t charge for that, and we let them know if they’re appropriate — we don’t push anybody, they decide for themselves. Therapy generally is a five-day treatment, people fly in on the weekend, we start Monday, get four hours of therapy a day Monday through Friday, and they’re done Friday afternoon, so they can fly home Saturday. All of our published research is based on that 20-hour program.

Lisa: And for the listeners, where are you located physically?

Larry: Our home office is in Gainesville, Florida, and we have trained therapists — two in London, one in Canterbury, England, one in St. Louis, one in Manhattan, New York City, one in Encinitas, north of San Diego, one in Beverly Hills, and one in Oakland, in the San Francisco area. We’re gradually growing, we need to find physical therapists with fabulous manual skills before we can train them on the correct procedure.

Lisa: Well, thank you so much for being here, I really appreciate you taking the time to share your experience and expertise. What you’ve done in terms of putting together the research and getting the word out is very inspiring, so I appreciate your time today.

Belinda & Larry: Thank you for having us, we appreciate it.

Lisa: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/315. I really encourage all of you listening to think about the physicality of our bodies — where is the uterus located in the abdomen, could there be adhesions, could there be ways to physically manipulate the area to improve circulation and lymph flow, and to break up adhesions without invasive surgery. If this topic interests you, head over to the show notes page, where I’ll list out the different modalities I’ve covered on the show that address this same concept in different ways. Imagine if we lived in a world where, instead of going straight to drugs and surgery, we looked at modalities like this first, as the least invasive first port of call. Thank you all for being part of the Fertility Friday community, and until next time, be well and happy charting.