As a physical therapist and nutritionist, Diane Kusunose knows a thing or two about the impact of nutrition on the body and mind. Day after day, she treats patients who suffer from poor gut health manifesting as inflammation, pain, and serious illness. She’s seen firsthand how our digestive systems can wreak havoc on other essential structures from the nervous system to the visceral system. To better understand the importance of the gut microbiome and its role in patient recovery, we caught up with Diane, owner of Insights for Natural Balance in San Diego, California.
It’s not uncommon for Diane’s patients to seek her out from a place of desperation. Their stories are similar: they’re juggling too many medications and supplements despite receiving little to no relief; battling constant pain; and dealing with digestion issues like constipation, gas, diarrhea, and bloating. To tackle the root cause, Diane begins by addressing the patient’s dietary habits as well as less obvious villains such as chemical imbalances from heavy metals or scar tissue. Her most common diagnosis? Leaky gut—a condition that is both the cause and effect of chronic inflammation and other digestive disorders that prevent so many from living full, happy lives.
An informal moniker that just recently gained recognition in the medical industry, “leaky gut” refers to intestinal permeability. “Essentially, it’s when your intestinal lining becomes compromised, allowing for food, bacteria, and toxins to seep into the bloodstream,” says Diane. “Leaky gut creates an imbalance of natural flora or ‘normal bacteria’ in your gut. It’s caused by a number of things like processed foods, pesticides, even the fluoride in our water.” Aside from common gastrointestinal disorders like pain, heartburn, and incontinence, leaky gut has been linked to mental health disorders—not surprising when we learn that over 90% of serotonin is produced in the gut! And while the science of gut health is relatively new, an explosion of research within the last five years reveals an association between dysbiosis and myriad health issues from headaches, sleep disorders, and fatigue to fibromyalgia, arthritis, and depression.
Notwithstanding individual diagnoses, you’d be hard pressed to find a nutritionist who disagrees with adding more plants to the average American diet. “Fiber from greens and fruit will go a long way,” says Diane. “If my patients can have raw dairy, I also recommend it since pasteurization denatures vital proteins and destroys the natural oils and enzymes in food.” She also advises they pay attention to common pantry staples like oil. “Oils can be anti-inflammatory or highly inflammatory, so be sure to check your labels. Look for cold processed oils when shopping and use ghee butter or coconut oil when cooking at high temperatures.”
Contrary to most marketing campaigns, there is no Holy Grail of diets. In Diane’s words: “Moderation is key, although moderation can mean something different for everyone depending on a person’s dietary habits. Generally speaking, most of my patients see major improvement following the 80/20 rule, or eating well at least five days out of the week.” As for general advice for people looking to reverse the signs of a damaged gut, Diane recommends a digestive enzyme to break down proteins, fats, and sugars. In her experience, clients need the extra help when their gut isn’t working properly, stating, “We are what we absorb, not what we eat.” As an added benefit, enzymes also help decrease inflammation.
So what does this mean for physical therapists and their patients? For starters, it validates the widely-held belief that our internal systems are inextricably linked and that we always need to be looking at the body as a whole. “I have patients who see a lot of success with Counterstrain treatments of the valves. But if they don’t eat healthy, their issues come right back.” Because of her experience in both industries, Diane promotes a combination of holistic food as medicine and Counterstrain physical therapy for the unhealthy gut. Just as PTs might refer a complex patient to their PCP, they’d benefit from recommending a nutritionist or dietician to further address inhibitors to the patient’s overall wellness. Not only can they utilize biofeedback tools and food sensitivity tests, these specialists can develop a personalized nutrition plan to better support the work being done in the clinic. Considering the gut microbiome is as unique to an individual as their fingerprint, there is no one-size-fits-all solution. And like most PTs who love a good challenge, we wouldn’t have it any other way.
For more information on physical therapy for the unhealthy gut, check out Fascial Counterstrain for the Nervous System.
Michael Wangsness, PT, DPT, ATC, CSC I, holds a Bachelor of Science in Athletic Training from Nova Southeastern University (2007) and earned his Doctorate in Physical Therapy from the University of Minnesota (2010). He began incorporating Fascial Counterstrain (FCS) into his practice in 2011 and has advanced to teaching roles, serving as a Teaching Assistant since 2016 and a Lab Instructor since 2020. In 2022, Michael was among the first to receive his CSC I certification. Passionate about FCS, he has been privileged to train extensively under Brian Tuckey. Michael currently practices at an outpatient clinic for M Health Fairview in Woodbury, MN. Outside of work, he enjoys golfing, coaching hockey, and spending time with his wife, Heather, and their three children: Olivia, Gavin, and Amelia.
Dr. Kim Braun, PT, DPT, brings over 30 years of experience to her practice as a doctor of physical therapy, with a focus on comprehensive pain and dysfunction treatment. She earned her initial PT degree from the University of Iowa and later completed her Doctor of Physical Therapy at St. Scholastica College. Passionate about infant care, Dr. Braun specializes in treating and preventing torticollis and plagiocephaly. Her dedication to patient-centered care is rooted in integrity, efficacy, compassion, and advocacy, utilizing a holistic approach for rehabilitation, prevention, and wellness. Dr. Braun has pursued extensive post-graduate study in the Fascial Counterstrain technique through the Jones Institute and with Brian Tuckey, PT, OCS, JSCCI, and is excited to leverage Counterstrain when other interventions have proven insufficient.
Shannon Arndt, MSPT, JSCC, is a distinguished physical therapist and owner of Soundview Center for Well-being, Lone Lake Physical Therapy, and Sage Counterstrain. She holds an MSPT from the University of Rhode Island, where she graduated at the top of her class, and is a Board Certified Specialist in Strain and Counterstrain. Shannon’s expertise extends to her work with The Bridge Back Project, where she uses counterstrain techniques to support veterans and first responders in their recovery from PTSD. Passionate about patient education, she thrives on uncovering the complex interconnections of physical impairments and empowering individuals to manage their health autonomously.
Randall Kusunose founded The Jones Institute in 1988 with Lawrence Jones, D.O., the original developer of Counterstrain. He was the first therapist to be board certified in orthopedics by the American Board of Physical Therapy Specialties in California. Randall has trained all Jones Strain Counterstrain Certified Instructors (JSCCI) in the U.S., France, Italy, and Australia, and developed over 60 Jones Strain Counterstrain techniques along with the Facilitated Counterstrain curriculum. When he’s not practicing, you can find Randall skiing, scuba diving, and relaxing on the sand in the beautiful beach town of Encinitas, California.
Brian Tuckey, a magna cum laude graduate of the University of Maryland School of Physical Therapy, became board certified in orthopedics in 1995. Under the tutelage of Lawrence Jones, D.O., Brian became one of only four physical therapists in the world to be certified in the Strain Counterstrain (SCS) technique. He was also the first practitioner to recognize Counterstrain’s impact on the fascial system which led to his development of Fascial Counterstrain (FCS) with over 800 anatomically-specific techniques in addition to the FCS Cranial Scan—a proprietary assessment that identifies dysfunction in all systems and regions of the body. When he’s not teaching, Brian is treating complex patients at Tuckey and Associates Physical Therapy in Frederick, Maryland.
Holly Christy earned a Bachelor of Science from the University of Washington, Master of Acupuncture from Northwest Institute of Acupuncture and Oriental Medicine, and Doctor of Naturopathic Medicine from Bastyr University where she currently teaches as an adjunct clinical faculty member. Holly started her practice in 2000 and became a lead instructor for Counterstrain Academy in 2014 after a mastery-level internship with Tim Hodges, LMT, JSCCI. In 2019, she became a Jones Strain Counterstrain Certified Instructor (JSCCI) of Fascial Counterstrain (FCS) for the nervous system. Though Counterstrain is her primary modality, Holly also offers primary care, acupuncture, prolotherapy, custom orthotics, and intravenous nutrient therapy.
Robert Dowd holds a Bachelor of Science in medicine with a certificate in physical therapy, Master of Healthcare Administration, and Doctor of Physical Therapy. Robert is now a Jones Strain Counterstrain Certified Instructor (JSCCI) who’s dedicated to presenting Counterstrain the way Lawrence Jones, D.O., advised his students to do at his final course offering. Robert applies the philosophy of Counterstrain to all clinical settings from the outpatient orthopedic clinic, acute care hospital, and ICU to the nursing home and hospice industry. When he’s not practicing in the Black Hills of South Dakota, Robert can be found writing, fishing, hunting, or riding his motorcycle.
Larry Ham graduated from the University of Southern California in 1978 with a Master of Science in physical therapy. He took his first Counterstrain course in 1986 after Lawrence Jones, D.O., treated him and successfully eliminated all back and sciatica pain. He’s now certified to teach Strain and Fascial Counterstrain courses for the spine and extremities and the viscera, respectively. In addition to teaching Counterstrain in the U.S. and Australia, Larry has served on the sidelines of over one thousand sporting events as a Certified Athletic Trainer. Though nearing retirement, Larry still practices in Spokane, Washington, and enjoys spending his free time with his wife, sons, and grandchildren. You can catch him scuba diving with sharks, remodeling his home, or hydrofoiling on the lake.
Tim Hodges has worked in the field of physical rehabilitation since 1996. Since joining The Jones Institute in 2004, he’s assisted Brian Tuckey, PT, OCS, JSCCI, in the development of several Fascial Counterstrain techniques and taught numerous Fascial Counterstrain courses as a certified instructor. Tim continues to apply his knowledge and expertise through Counterstrain Academy—a mastery program designed for licensed Counterstrainers throughout the country. In addition to developing the program’s curriculum and overseeing its mentorships, Tim is currently practicing at Counterstrain Portland, his Oregon-based private practice.
Eryn Milian earned a Bachelor of Science in chemistry and environmental science from William Smith College along with a Doctor of Physical Therapy and PhD from the University of Miami. Her doctoral work focused on anatomical sciences and measurable outcomes which inform her current clinical expertise in orthopedics and sport physical therapy. Since joining the University of Miami’s faculty in 2013, Eryn has expanded her role as assistant professor to become a course master for neuroanatomy and instructor for both pelvic anatomy and the university’s orthopedic, sport, and neuroscience residency programs. Her research interests lie primarily in knee injuries and the development of reliable and valid measures of assessing ACL risk in adolescent athletes via musculoskeletal ultrasound.
Greg Zadow has been a self-employed physical therapist since 1998. He earned a Bachelor of Applied Science in physiotherapy from the University of South Australia and Doctor of Physical Therapy from the Rocky Mountain University of Health Professionals. Greg is the owner and clinic director of Green Ridge Physical Therapy and Wellness, his Oregon-based private practice. In 2011, he became certified in the Strain Counterstrain (SCS) technique and continued on to complete a mastery program with Counterstrain Academy and become a Jones Strain Counterstrain Certified Instructor (JSCCI) of Fascial Counterstrain (FCS). Greg has been using Counterstrain ever since his first introduction to the technique in 1991 and now holds over 20 years of continuing education experience in the field of manual therapy.
Kyle graduated from San Diego State University in 2010 with a bachelor’s degree in kinesiology and earned a Doctor of Physical Therapy from the University of Miami in 2014. Kyle immediately started his private practice and became certified with The Jones Institute after witnessing the powerful effects of Counterstrain on his patients. Kyle currently lends his expertise to the Doctor of Physical Therapy programs at both San Diego State University and the University of Miami. Since joining The Jones Institute as a lab instructor in 2015, Kyle has taken on additional roles in managing the company’s domestic headquarters, developing the curriculum for a new anatomy program, and teaching Anatomy Dissection as the lead instructor.