My Experience with the Clear Passage Approach to Treating Abdominal Adhesions
It had been a long six years. Following remission of the non-Hodgkin’s lymphoma diagnosis that filled my abdominal cavity with tumors, I still suffered from periodic episodes of small bowel obstruction secondary to deep scar tissue known as adhesions. Although infrequent, these episodes were severe, traumatic, and occasionally resulted in hospitalization.
Exercise, dietary change, and bodywork were key to staving off some brewing episodes, but other times a complete obstruction would blindside me when the stress of life or consuming too much fiber in a meal clogged up the small intestine. It was after a bad episode that I resolved to contact Clear Passage.
Headquartered in Gainesville, Florida, Clear Passage is a physical therapy clinic specializing in resolving abdominal and pelvic strictures through a manual physiotherapy technique refined over the last few decades. Today, Clear Passage treats two main conditions: infertility because of blocked fallopian tubes and small bowel obstruction. Scar tissue in these areas of the body may come from different causes, including surgery, radiation, tumors, or endometriosis. Yet each process shares the common effect of potentially damaging surrounding tissue, resulting in the formation of adhesions.
Adhesions are composed of connective tissue—thin but strong bands of collagen that inappropriately anchor viscera such that they don’t move freely. This was the case for me, with sections of my small intestine getting glued to the abdominal cavity and occasionally obstructing motility. The premise of Clear Passage is simple: Stretch these adhesions, free the surrounding tissue, and restore healthy function.
With backgrounds in physical and massage therapy, Larry and Belinda Wurn are the creators of the technique and process they later trademarked as the Wurn Method®. Their early work was with women struggling with infertility due to scar tissue along the fallopian tubes. They discovered that fallopian tubes blocked by strictures could be liberated manually (as opposed to surgically), restoring normal ovulation in an average of 16.2 hours of therapy. They rounded the total up to 20 hours to cover those falling on the other side of the curve, and that amount became their standard of care for a course of treatment.
With this foundation set, the Wurns were confident condensing their treatment course to four hours of a therapy a day for five days straight, creating an intensive program for patients traveling to their clinic. This later became the standard for small bowel obstruction, with the expectation that these patients would continue self-care at home for several months following the intensive treatment.
This is where I enter the story. On a low-residue diet for four months after my last bowel obstruction and still suffering from minor gastrointestinal upset, I arrived at Clear Passage mindful of research suggesting that the therapists trained in the Wurn Method are the experts in freeing restrictions around organs. For those considering this therapy and wondering what to expect, what follows summarizes my treatment and observations.
The first session was an assessment of basic posture and range of motion, documented with photographs and goniometer measurements. Along with a questionnaire and previously completed intake forms, a quick conversation framed the treatment to come. Therapy commenced in two-hour sessions: an early morning session followed by a break of an hour or two and then a session with a different therapist.
Most Clear Passage clinics around the world are staffed with one therapist, but the Gainesville clinic can see up to four patients per week and employs multiple providers. I appreciated having two sets of eyes and two sets of hands assessing and addressing different aspects of my treatment as per their expertise. During the break between sessions, the therapists compared treatment observations and discussed next steps.
Treatment entailed different modalities of bodywork, mostly focused on the abdomen, and primarily addressing restrictions there with the Wurn Method. As a proponent and practitioner of holistic medicine, I’ve received a lot of bodywork over the years, benefiting from the gentleness of craniosacral therapy and the intensity of Rolfing structural integration, and everything in between. The Wurn Method is a combination of myofascial release (MFR) and visceral manipulation (VM), with longer hold times and deeper penetration to access the fascia surrounding abdominal and pelvic viscera.
With MFR, I experienced a gentle compressing of fascia for at least two minutes or longer until there was a “release” or sliding of the connective tissue. At face value, MFR does not claim to address the organs directly, purporting that indirect work on the fascia can result in deeper releases of stagnant tissue.
On the other hand, practitioners of VM are masters of locating and accessing the viscera, feeling for each organ’s “embryonic rhythm” and restoring motility to enhance function. They generally don’t hold or compress the tissue at length, which negates addressing the fascia surrounding the organ.
The Wurn Method combines these techniques, getting to a depth sufficient to address the viscera and holding as long as necessary to release any strictures binding the fascia layers of that organ. This technique, with the concentrated nature of the therapy stacking four hours of treatment in a day for five successive days, constitutes what I believe to be the secret sauce of the Wurns’ success.
Therapy was intense at times but never excessively so. While some deep and long holds in my belly were uncomfortable, it was never so much so that I couldn’t relax around the sensation. This is important as any tensing up around the therapy is counterproductive. The therapist cannot access the deeper viscera if the intensity is such that it elicits a contraction of the abdominal muscles in a guarding response. Thus, the Wurn Method must be performed to each patient’s comfort level.
Besides a focus on the abdominal cavity, the holistic nature of the therapy included one session of basic craniosacral therapy, education on self-care bodywork for the abdomen, instruction in using a foam roller to release contributing chronic hip and back tightness, and two sessions of rectal assessment to diagnose and address coccyx subluxations and pelvic floor tightness. This marks the gestalt of the therapy, being mindful of all the interconnecting parts that influence how the abdomen and pelvis move and function.
How has treatment at Clear Passage benefited me? In terms of outcome, it is too early to tell. A promising early indicator of success was returning to a normal diet without issue. The chronic lower-left back pain that stems from soft tissue adhesions surrounding the left renal vein has also improved. If I don’t have another episode of small bowel obstruction in the years ahead, that will mark the complete success of the therapy, and it will have been very much worth the time and expense.
I was successful in convincing my health insurance company (which initially rejected the out-of-network referral to Clear Passage made by my oncologist) to cover the therapy during a grievance process. Many will not have such luck and will be required to pay out of pocket for the therapy. The total cost of treatment at the time of this writing is $7,500. Divided into 20 hours of therapy, that’s $375/hour for specialized physical therapy. The average out-of-pocket cash price for physical therapy ranges from $75 to $150.
With Clear Passage, you are paying a premium for the intellectual property that is the Wurn Method. Although in theory, one could piecemeal a similar course of therapy with local providers of MFR and VR, the gold standard for releasing abdominal and pelvic adhesions is treatment at Clear Passage. Clinicians there have the benefit of time and experience, as case studies from patients treated at the facility will attest.
My main criticism of the clinic is the Wurns’ decision to protect their intellectual property by only training a limited number of providers, who must come to their Gainesville headquarters for training. There are pros and cons to this approach. It ensures that those falling under the Clear Passage banner have the requisite expertise to get optimal results. The downside is that limiting training also hampers accessibility to a therapy that can benefit thousands of patients. As market forces dictate, scarcity of providers trained in the Wurn Method also underlies the hefty price they can demand.
If criteria for competency were defined and learning objectives clearly outlined, the Wurn Method could be another modality broadly offered in continuing education programs for physical therapists and bodyworkers of all disciplines. It is my sincere gratitude for this therapy that is driving my criticism. If it were subpar, I wouldn’t feel the need to write about my experience. The care I received there was exemplary, and I know how many patients can be relieved from the anguish of small bowel obstructions by the hands of a Wurn Method-trained provider.
Leaving Clear Passage, I had the sense that this was not the end of my journey but the beginning. Things have shifted, but most importantly, I feel empowered to build inertia behind the work received with self-care in the weeks and months ahead.