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Back Pain and Physical Activity

From Physical Therapy at Synergy Fitness for Her

Don’t Let Back Pain Derail Your Commitment to Exercise
Within weeks of belting out the final stanza of “Auld Lang Syne,” a large segment of those resolving to exercise more in the New Year will be on the sidelines. The cause? A variety of injuries and conditions ranging from stress fractures and twisted ankles to the biggest culprit of all, low back pain.
A Global Burden of Disease, Injuries, and Risk Factors study recently cited low back pain as the single leading cause of disability worldwide. Estimates indicate that 80% of us contend with the common
ailment at some point in our lives. The intense and debilitating pain that accompanies low back injuries
often prevents sufferers from going to work, participating in household chores and enjoying time with
loved ones.

Low back pain doesn’t have to be a prescription for couch surfing. Current studies show no evidence that supervised physical activity increases the risk of additional back problems or work disability. Counter to the age-old recommendation of inactivity, a customized exercise program under the direction of a physical therapist is widely prescribed to reduce pain and disability.

“In my practice I see clients with recent back injuries as well as clients who have been held back from doing the things they enjoy for years due to back problems”, stated Birgit Reher, physical therapist at Synergy Fitness for Her in Durham NC. “While a recent back problem tends to get resolved more quickly and completely, it is very rewarding to see even longstanding issues improve with the right care.”

Although back pain can affect anyone, the major risk factors include age, poor physical fitness, genetics,
being overweight, and smoking. The National Institutes of Health suggests the following to prevent back
pain:
• Exercise frequently and keep your back muscles strong.
• Maintain a healthy weight.
• Eat a balanced diet, including daily recommendations for calcium and vitamin D.
• Focus on body mechanics by standing up straight and lifting heavy objects with bent legs and a
straight back.
According to the American Academy of Orthopedic Surgeons, low back pain sufferers should prioritize a
supervised exercise program and a gradual return to everyday activities to restore back strength.
Following an evaluation, physical therapists can recommend specific exercises to prevent and treat back
pain, and provide additional treatment options to address pain and restore mobility.

About The Private Practice Section of the American Physical Therapy Association
Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions
the success of physical therapist-owned businesses. Our members are leaders and innovators in the health care system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more
information, please visit www.ppsapta.org.

Birgit Reher PT, a physical therapist at Synergy Fitness for Her, is a member of both the APTA and the Private Practice Section


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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome-Physical Therapy vs Surgery

Carpal tunnel syndrome is a common problem leading to wrist and hand pain, tingling, numbness and weakness.  It is caused by pressure on the median nerve as it passes from the forearm through a small tunnel into the wrist and hand.  This pressure is generally caused by swelling that narrows this small tunnel and can be caused by repetitive wrist motions, pregnancy, or diseases such as rheumatoid arthritis, diabetes, and hypothyroidism.

Treatment options include surgery and physical therapy.  A recent study of 100 women randomly assigned to either surgery or physical therapy showed equal outcomes in self-reported function, pinch grip and symptoms.
http://www.jospt.org/doi/abs/10.2519/jospt.2017.7090


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Plantar Fasciitis

 

Oh my aching feet….

Foot and heel pain is a very common complaint among athletes and non-athletes alike.  Plantar fasciitis is a very common condition causing heel pain.  Symptoms usually start suddenly, often occur after a rapid increase in activity and are felt as a stabbing pain on the bottom or side of the heel, or as a sensation of tenderness or tightness along the arch.  

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue that supports your arch and connects the ball of your foot to the heel.  This tissue can become inflamed with repetitive weight-bearing activities.  This condition can develop in athletes and non-athletes alike.

Symptoms are usually worst when getting out of bed in the morning taking the first few steps, standing up after prolonged sitting, after prolonged standing, after walking barefoot or in shoes with poor support, or after an intense weight bearing activity such as running or stair-climbing.  Frequently, people report that symptoms improve over the course of the day as the body warms up, but then progressively get worse later in the day with prolonged walking or standing.

 

What are the risk factors for developing Plantar Fasciitis?

  • Age over 40
  • Sudden increase in running or other weight bearing activity
  • Prolonged standing with work or leisure activities
  • Increased body weight
  • Decreased flexibility in calf muscles
  • Walking barefoot or in shoes with poor support
  • A tendency towards a flat foot, increased pronation

 

How can I prevent Plantar Fasciitis?

  • By regularly stretching your calf and foot muscles, especially before and after walking and running
  • By wearing well-fitting shoes with good arch support
  • By replacing your shoes regularly so that they provide good shock absorption
  • By maintaining or regaining a healthy body weight
  • By working out smartly, including a warm- up with your exercise program and gradually building up the duration and intensity of your program

A few exercises that can help you improve flexibility through your ankles and fascia:


Stand with arms against the wall or solid surface 
Standing Calf Stretch – sideview

Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day

If the standing ankle stretch is too uncomfortable, this seated stretch is a good alternative.

Seated towel or belt stretch

Sit with your affected foot in front of you. Place a belt at the base of your toes and pull back, stretching the long plantar ligament.
Repeat 3 Times
Hold 1 Minute
Complete 1 Set
Perform 2 Time(s) a Day

Plantar Fascia-Self Stretch

Grasp foot and pull big toe towards you as far as you can while fully dorsiflexing ankle simultaneously.
Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day

Plantar Fascia-Self Stretch

Grasp foot and pull big toe towards you as far as you can while fully dorsiflexing ankle simultaneously.
Repeat 2 Times
Hold 30 Seconds
Complete 1 Set
Perform 2 Time(s) a Day


Sit on the edge of a bench or a chair. Place a tennis ball on the ground and place your involved foot on the ball. Apply pressure and run your foot back and forth over then ball, massaging the underside of your foot. Don’t press so hard that you are in pain.

Repeat 20 Times
Hold 2 Seconds
Complete 2 Sets
Perform 2 Time(s) a Day

I think I may have Plantar Fasciitis. What can I do?

  • The first step is to see your physical therapist for an evaluation to diagnose the problem.  She will take a thorough history and perform an assessment to ensure that your symptoms are not caused by other conditions
  • If you indeed have Plantar Fasciitis, your therapist will teach you exercises to improve flexibility of the ankle and plantar fascia
  • She may also perform some myofascial work to speed up restoration of flexibility
  • Other components of treatment may be instruction in ice massage, instruction in exercise program modification, education re footwear selection, assessment for need of orthotics, use of night splints, or taping

Of course, the best thing is to prevent Plantar Fasciitis in the first place, but if you have developed this condition, it is worthwhile to get it checked out promptly.  Most of the time symptoms can be resolved with conservative measures, so that you feel better and can get back to the activities you enjoy.

 


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9 Things You Should Know About Pain

9 Things You Should Know About Pain

 

  1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.
  2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, others experience minor injuries with a lot of pain (think of a paper cut).
  3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding may not be the cause of your pain.A study performed on individuals 60 years or older who had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated or bulging disc, upon diagnostic imaging.
  4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.
  5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.
  6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts.
  7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).
  8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a “roadmap” within the brain that details a path to each part of the body may be a bit “smudged.” (This is a term we use to describe a part of the brain’s virtual roadmap that isn’t clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)
  9. There is no way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”Read more about Painand Chronic Pain Syndromes.

The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our #ChoosePT page.

Author: Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC


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10 Natural Solutions to Ease your Low Back Pain and Stiffness without Medications, Expensive Tests & Referrals

downloadIntroduction

Are you or someone you are living with suffering from back pain or stiffness? About 80% of Americans will experience back pain at some point in their lives, and it can have an impact on many parts of life. It can affect sleep, mood, work and finances, relationships, ability to do housework or gardening, and enjoyment of cherished activities from playing with the grandchildren to playing a round of golf, a game of tennis or going for a run. Many people think of back pain as an inevitable part of ageing or put it down to stress or lack of exercise. They may have been told by friends or even healthcare providers that nothing can be done other than rest and medication.

In this report I share 10 very powerful strategies that I have found to work for many of my patients over the past 15 years. They are in no particular order, but they all work. Without knowing your specific history and root cause of pain I cannot tell you which strategy will work for you, but in trying out some or all of the strategies described you may go a long way in feeling
better and regaining your active and healthy lifestyle and joie de vivre.

10 Natural Solutions to Ease Your Low Back Pain and Stiffness without Medications, Expensive Tests, and Referrals

1. Avoid Sitting For More Than 20 Minutes At A Time

Your body is not designed to spend much time sitting. When you sit there is about 10 times as much pressure pushing down on your spine than when you stand tall. This happens because we tend to slump or slouch, which does not allow the muscles supporting the spine to work efficiently. Even if you do sit up with good posture initially, the muscles supporting your back will fatigue if you sit uninterrupted for more than 20 minutes. This inevitably causes stiffness, aches and pain. Even just getting up and moving around for a couple of minutes regularly can make a big difference.

2. Avoid Sleeping On Your Stomach

When you sleep on your stomach every part of your spine, from the neck down to the low back, is twisted and in the wrong position. Over time, this can cause a lot of imbalances, damage and pain in your spine.

3. Use Ice

Ice is a great tool to relieve an achy or painful back. It decreases inflammation and has a natural local anesthetic effect. So if you feel achy at the end of a busy day apply an icepack to your back for 10 to 15 minutes. You can do this every couple of hours if needed.

You may wonder when to use heat. Heat can be helpful if your back feels stiff in the morning. Applying a hotpack or hot water bottle for 10 minutes can make it easier for you to loosen up.

4. Avoid Carrying A Bag, Purse Or Backpack On The Same Side Every Day

When you consistently carry a load on one side your spine will have uneven pressure on it. Over time this may adversely affect your posture as your spine may curve sideways and cause decreased mobility and pain.

5. Wear Proper Footwear

Wearing high heels changes your posture and increases the pressure going through your back by about 25 times. Also wearing unsupportive shoes including flip-flops and sandals can put extra pressure on your back, hips and knees. Of course this is a cumulative effect that develops over months and years, and often results in pain and stiffness in the 40’s, 50’s and beyond. Just changing your footwear to something supportive that can absorb a lot of the shock going through your body with each step can dramatically decrease the pressure on your back and decrease or eliminate your back pain.

6. Sleep With A Pillow Between Your Knees

If you sleep on your side, try putting a pillow between your knees. While this may take a few tries to get used to, this technique can really help your back as it helps keep your spine in better alignment and decreases the tension in your low back.

7. Maintain Good Posture

Your regular daily activities, if done with poor posture, cause cumulative strain on your back. Tasks such as leaning over the sink to brush your teeth or leaning over the kitchen counter preparing food can increase pressure in your back about 50 percent. If you are standing at the kitchen counter for a while try to put one foot up on a small foot stool or open the cabinet door and step one foot on the bottom ledge to relieve some pressure in your back.

8. Use Your Endorphins

Your body can naturally produce endorphins, which are hormones that can be as effective as pain medication in blocking pain signals to your brain. You can get your body to produce these pain relieving hormones through aerobic exercise such as walking, or relaxation and meditation techniques. There are free guided meditation podcasts and apps available.

9. Try Pilates Or Yoga

These are well established systems of exercises that can help you become more aware of your posture and areas of tension, improve flexibility and increase muscle tone and control through the core muscles supporting your spine.

10. Give Physical Therapy A Try

This tip will provide you with the fastest relief from back pain and stiffness. With back pain, many people focus just on the symptoms rather than the underlying cause. Physical therapists are movement specialists who can determine the underlying cause and help you restore mobility, reduce pain and improve quality of life. Therapy may include manual therapy help you relax tight muscles or loosen stiff and stuck joints as well as exercises to improve your alignment and strengthen your core muscles.

Most people don’t realize how easy it is to get access to physical therapy. You don’t need a referral from a physician, unless you are on Medicare. You will likely be able to avoid expensive unnecessary tests and medications and quickly get back to doing the things you enjoy. Our clinic can help get you on the right track.

For more information contact me at birgit@synergyfitnessforher.com or: 919-402- 0888


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7 Simple Ways to Live with Less Neck and Shoulder Pain without Medication

Spine

Birgit Reher PT


Introduction

If you or someone you live with has problems with neck or shoulder pain or stiffness, you know how much that can interfere with your day-to-day life. It may make it difficult to get restful sleep, work at a desk or computer, to do any kind of overhead activities from painting to playing tennis, cause difficulty with lifting up a grandchild or carrying a bag of groceries. Sometimes, what starts with stiffness or soreness in the neck and shoulder area even progresses to a headache. Whether you are dealing with an occasional flare-up or constant chronic pain or stiffness, there is usually something you can do to help yourself feel better and get back to an active lifestyle.
In my experience over the past 15 years I have found some basic interventions that frequently have resolved neck or shoulder issues. In the report below, I have listed 7 helpful tips for you to try to relieve your symptoms and lead a happier and more comfortable and active life

1. Get Up and Move Frequently Throughout the Day
If you work at a desk job or otherwise spend much or you day sitting, take frequent short breaks. Our bodies are designed for movement. In sitting there is about 10 times as much pressure on your spine as in standing tall. Getting up for micro breaks of one or two minutes to take a few steps every 20 to 30 minutes can really help take stress off your spine and make your neck feel much better. If you have to spend much of your day on the phone try to stand up while talking on the phone. Even while sitting try to change your position frequently. If you need a reminder to get up there are free phone apps available that can do that job for you.

2. Actively Relax Tension
Most of us carry our stress and tension in our neck, unconsciously pulling up our shoulders and tightening the muscles around the neck. This can cause pain and stiffness in our neck and shoulders and even lead to headaches over time. Doing a few simple exercises can relieve neck and shoulder strain and tightness. Some examples include: rolling your shoulders up back and down a few times, squeezing the shoulder blades back and down, gently stretching the neck by tilting your head bringing one ear closer to the shoulder or turning your head looking over one shoulder. These exercises should not cause any pain.

3. Avoid High Heels
Wearing high heels increases the pressure through your back and spine by as much as 25 times. It causes changes in the alignment of your neck and shoulders, hips and knees, changing the way you stand and walk. The effect is cumulative over time, so usually by the 40s can lead to neck and shoulder pain or stiffness and low back issues.

4. Avoid Carrying a Bag on the Same Side Every Day
If you carry a bag on one shoulder every day it adds a lot of pressure on that side and cause your spine to curve sideways. Not only will your head and shoulder to be in an altered position, but also your natural gait will be thrown off. Over time, this can damage muscles and joints and muscles on one side will shorten in response leading to stiffness and pain. There are plenty of things you can do to prevent this. Using a backpack with two wide straps to distribute weight is the best solution. If that is not an option, try to at least lighten your bag as much as possible and alternate sides you carry the bag on.

5. Avoid Sleeping on Your Stomach
Sleeping on your stomach causes severe stress on every part of your spine. It forces your neck to be rotated to one side and the low back to arch leading to additional strain and over time and can cause neck, shoulder and back pain.

6. Find the Pillow that Works for Your Body
Sleeping with a pillow that is wrong for you can interfere with your sleep quality and have you waking up with a stiff or painful neck. The pillow you select should keep your neck in a neutral position. If you sleep on your side the pillow should be just the right thickness to fill out the space between your head and mattress without tilting your neck sideways up or down. Therefore, the pillow thickness you need depends on how wide your shoulders are. If you sleep on your back, your pillow should also keep your neck in a neutral position, which means your chin should be neither tipped up or down.

7. Consult a Hands-On Physical Therapist
If you have tried the tips outlined above and still have neck or shoulder pain that keeps you from doing the things you enjoy, seek help from a hands-on physical therapist before pain gets out of hand. A therapist can assess you, treat the underlying cause of your symptoms, and often very quickly relieve your pain. The therapist may also teach you techniques and exercises to help you eliminate your symptoms and get you back to a full and active lifestyle.

For more information or to schedule a visit with a therapist, contact Birgit Reher PT at birgit@synergyfitnessforher.co or call 919-402-0888.

Health Advice Disclaimer
We make every effort to ensure that we accurately represent the injury advice and prognosis displayed through this Guide.
However, examples of injuries and their prognosis are based on typical representations of those injuries that we commonly see in our physical therapy clinic. The information given is not intended as representations of every individual’s injury. As with any injury, each person’s symptoms can vary widely and each person’s recovery from injury can also vary depending on background, genetics, previous medical history, application of exercises, posture, motivation to follow PT advice and various other physical factors.
It is impossible to give a 100% complete accurate diagnosis and prognosis without a complete physical examination, and likewise the advice given for management of an injury cannot be deemed fully accurate in the absence of this examination from a licensed physical therapist at Synergy Fitness for Her.
We are able to offer you this service at a standard charge. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied in this report.

 

Copyright Notice
©2016 Synergy Fitness for Her-Fitness Prescription LLC
All rights reserved
Any unauthorized use, sharing, reproduction or distribution of these materials by any means, electronic, mechanical, or otherwise is strictly prohibited. No portion of these materials may be reproduced in any manner whatsoever without express written consent of the publisher. Published under the Copyright Laws of the USA by:
Synergy Fitness for Her- Fitness Prescription LLC, 1125 W. NC Highway 54, Suite 404, Durham, NC 27707
www.synergyfitnessforher.com


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Strawberry Coconut Protein Shake

 

Quick and easy breakfast idea-Strawberry Coconut Protein Shake

Sweet-Strawberry-Smoothie copy

Ingredients:
1 serving vanilla or chocolate protein powder
8 oz unsweetened almond milk
1/2 C. frozen strawberries
1 tsp coconut extract
Optional: 1 Tbsp Barlean’s Omega Swirl (or your version of Flax oil, Flax Seed or Chia Seeds)


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Yonanas Banana Chocolate Protein Frozen Yogurt

banana

Ingredients:

 

  • 4 small spotted ripe bananas frozen
  • 1 ½ cup of skim milk
  • 1 scoop of Chocolate Protein Powder

Preparation:

 

  1. Peel and freeze spotted ripe bananas for 24 hours. Mix protein powder and skim milk thoroughly, pour into ice cube tray and freeze.
  2. 10 minutes prior to processing frozen bananas and protein, pull from freezer and allow to begin to thaw.
  3. After 10 minutes, begin by inserting one banana then add frozen protein powder and milk. Continue to alternate inserting the banana and protein cube into a blender.
  4. Stir mixture to evenly distribute texture and flavor.
  5. Portion mixture into 4 equal servings into separate containers for future snacks.

Each serving is 145 calories 27 g carbs 10 g protein and less than one gram of fat. Not bad for something that tastes so good and with no added sugar!

 


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Seeds Community Garden Supply List

seedsNot interested in yoga but want to help with our community organization this month?

Seeds has submitted an extensive list of needed supplies. Donated supplies will be collected in the studio throughout the month of February!

15- pairs bypass-style corona-brand hand pruners (remind them to use our Amazon Smile)

10- pairs holsters for pruners

10- bahaa-brand folding saws (on sale now)

2- corona 1 1/2″ easy-cut Loppers

5- 3/4″ hose shut-offs

5- hose heads

10- weeders

12- nail brushes

12- Small-sized gloves


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7 Ways to Avoid Falling off the Healthy Eating Wagon

1. Don’t Starve Yourself

Eating is a basic human need. Cut your calories in half over night or slash any specific food group out altogether for a prolonged period and you’ll land flat on your face in no time flat. When you’re eating for good health, you still need to eat. You’ll just need to go with healthy options and avoid eating more than your body needs to fuel itself through the day.

2. No Excuses

There are as many excuses to fall off the healthy wagon as there are days in a year. So if you’re going to stay on the wagon, you’re going to have to ignore the excuses and focus in on your goal: eating the right stuff. Which brings us to the next way to avoid falling off the wagon…

3. Stay Focused

Being mindful of your healthy eating ways is easy during the first few days. After all, you’ve spent years eating one way and now you’re changing everything up. In a week or so, however, it can be difficult to remember your desire to eat healthily and even harder to remember why you made that decision. Stay focused on your choices and why you made them to stay strapped tightly on the wagon.

4. Get on the Right Wagon

Every person’s health goals and expectations are different. If you hop on a healthy eating wagon for the first time in your life and expect to shed 30 pounds in a week, you’re going to be disappointed. Setting appropriate goals will help you stay on the wagon and help you make the next goal, as your wagon gets easier and easier to ride to the finish line.

5. Avoid Naysayers

Always struggled with your weight? Tried every diet plan known to man without success? Then you’re going to have a lot of folks who scoff at your desire to eat healthily. Let them scoff on their own and find new friends if you have to. Once your lifestyle changes start to pay off, strut by the folks who said they’ll believe you’re serious about healthy eating when they see results and watch their jaws drop.

6. Stay Away from Triggers

The reason healthy eating is difficult for so many is that unhealthy eating tastes so good! Understanding this and understanding when you most want unhealthy food options will help you stay on the healthy wagon. Have a hard time saying no to sweets at your best friend’s house? Invite him to your place or meet at the park. Eat everything in sight when you’re lonely? Give someone a phone call when no one is around.

7. Know How to Get Back On

You should aim to stay on the healthy eating wagon all day every day. But you should also be ready when you fall off. While you can find any number of ways to get back on the wagon, the best is to just do it! Admit you goofed up, recommit yourself to healthy living, and start living the healthy life you deserve once again. hungry


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