Posts Tagged ‘pain’

Post Workout Recovery Techniques

January 5th, 2010

You’ve just finished another gruelling workout.

Now what?

If you’re like Tiger, you’re going to stagger into the change-room, grab a quick shower and head off to the nearest Hooters.

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And like Tiger, you would be WRONG

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When it comes to getting fit/healthy/buff/ripped/sexy/etc, your workouts are only half the equation.

The other half of the equation is Workout Recovery.

And because I love you guys so darn much, here are my top Post-Workout Recovery Techniques.

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  • Post-Workout Carb/Protein Shake
  • Hot/Cold Contrast Showers
  • Fish Oils
  • Meditation / Sleep
  • Epsom Salt Baths
  • Ice
  • Massage
  • TENS
  • Chiropractic / Acupuncture
  • Traumeel

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Post-Workout Carb/Protein Shake

I have talked about this technique before. Simply put, it’s a no-brainer.

Post workout and your muscles are screaming for nutrients.

Ignore that message and your workout recovery goes into slo-mo.

Heed the message and the repair goes into overdrive.

More info here.

Hot/Cold Contrast Showers

Alternate between 30 seconds of cold water and two minutes of hot water. Perform this shrinkage inducing protocol three or four times.

While most of the claims about this recovery technique are anecdotal, there is some research showing that alternating hot/cold showers post-exercise is effective in lowering both heart rate and the levels of lactate in your blood.

Anecdotally, contrast showers have been said to improve athletic recovery via increased blood flow and possible nutrient and waste product elimination (lactate). There may also be a psychological benefit and an increased feeling of alertness and fatigue reduction.

In my personal experience, contrast showers help reduce my post-workout DOMS (delayed onset muscle soreness) as well as perk me up for the rest of my day.

Fish Oils

Your workouts cause inflammation.

Localized inflammation in joints and muscles. Systemic inflammation throughout your body.

Fish oils are a great, natural, anti-inflammatory.

Add some to your post-workout shake. If you already have issues with chronic inflammation, you may want to consider adding some Turmeric/Curcumin or Zyflamend into the mix.

Meditation / Sleep

High intensity workouts can be tough on the CNS (central nervous system)

And while there are lots of supplements (natural adaptogens & pharmaceutical agents) out there that claim to help repair & restore the CNS, I don’t feel comfortable recommending any of them.

However, I am willing to push meditation & sleep as the two best CNS treatments ever invented.

Sleep – You probably don’t sleep enough already. Add in a tough workout routine and you’re looking for trouble. Get your 7-8 hrs.

Meditation – There are lots of ways to meditate. There are crunchy-granola yoga meditative techniques. There are medical based mindfulness meditation programs. Praying is a form of meditation. There are even mp3s you can buy that claim to help sync your brainwaves into the pattern best suited for meditation. But the simplest method may be to just sit or lie down, put your hands on your belly and focus as your breath flows in and out.

Epsom Salt Baths

Epsom Salts (magnesium sulfate) are another anti-inflammatory agent.

When added to a nice hot bath, they are absorbed through the skin and helps reduce muscular pain and general “achiness”. It also helps increase your levels of magnesium and may help reduce water retention.

Ice Massage

The benefits of ice massage are questionable at best. But, I know a lot of athletes who swear by it, so I figured it best to include it in this review.

Most of the pro-Ice Massage evidence is anecdotal. The main claim is that ice massage is an effective method for reducing localized inflammation and reducing the symptoms of DOMS.

However, the clinical research doesn’t agree. In fact, some researchers feel that ice massage should be contraindicated when it comes to preventing post-exercise DOMS.

So, I leave the decision up to you.

Personally, I will skip the post-workout ice massage. If you need more info, click here.

Therapeutic Massage

There are many different types of massage.

Medical research has shown that the benefits of massage include pain relief, reduced levels of anxiety and depression, and temporarily reduced blood pressure, heart rate, and state anxiety.

Plus, it just feels gooooood.

Get a massage every month or so. Your body will thank you.

TENS

TENS is a non-invasive, medically tested, safe nerve stimulation intended to reduce pain, both acute and chronic.

It’s also the subject of cheesy late night infomercials.

And that’s too bad. Because, in my experience, TENS is a great little tool for reducing muscular pain.

I bought a unit two years ago after a car accident screwed up my neck, back, shoulder & knee. It wasn’t my only treatment modality, but it was convenient, effective and relatively cheap.

For post-workout pain, a TENS unit is probably overkill. But, for those older trainees who have a few chronic aches and pains, a TENS unit might be worth it’s weight in gold.

Chiropractic / Acupuncture

I group these two treatment modalities together because my chiropractor is also an acupuncturist and soft-tissue therapist. I don’t get one without the other.

I go every two months and Sheldon works out the kinks that I have managed to create.

When I over-do the chin-ups and my bad shoulder acts up a little, Sheldon breaks out the acupuncture needles, re-adjusts the bones and does a little (excruciating) muscle stripping.

45 minutes later and I am a new man.

As you can see, I can’t say enough about it.

Traumeel

Traumeel is a homeopathic anti-inflammatory.

And, according to researchers, it works better than NSAIDS at reducing chronic inflammatory conditions as well as systemic inflammation caused by exercise.

Plus, you get none of the unpleasant side-effects associated with NSAIDS.

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Well, there you go. There’s my list of Post Workout Recovery Techniques.

Feel free to comment if you think I have missed something or if you disagree with one of my choices.

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Is There A Link Between Exercise and Arthritis?

November 30th, 2009

knee pain jointAccording to a study being presented today at the annual meeting of the Radiological Society of North America, “Middle-aged men and women who engage in high levels of physical activity may be unknowingly causing damage to their knees and increasing their risk for osteoarthritis”.

“Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis.”

And in case you didn’t know…Osteoarthritis is a degenerative joint disease that causes pain, swelling and stiffness. According to the Centers for Disease Control and Prevention, osteoarthritis is the most common form of arthritis and affects approximately 10% of the American population.

The Study

The study involved 236 asymptomatic participants who had not reported previous knee pain – (136 women and 100 men, age 45 to 55, all within a healthy weight range.)

The participants were separated into low-, middle-, and high-activity groups based on their responses to the Physical Activity Scale for the Elderly (PASE) questionnaire. PASE is a standard test that scores an older individual’s physical activity level, based on the type of activity and the time spent doing it.

Then came the MRIs.

Radiologists scanned the knees of the test subjects and compared their findings to the levels of physical activity as determined by the PASE questionnaire.

Sadly, the MRI analysis indicated a relationship between physical activity levels and frequency and severity of knee damage.

tiger woods knee

The Details

Specific knee abnormalities identified included meniscal lesions, cartilage lesions, bone marrow edema and ligament lesions. Abnormalities were associated solely with activity levels and were not age or gender specific.

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  • The prevalence of the knee abnormalities increased with the level of physical activity.
  • In addition, cartilage defects diagnosed in active people were more severe.
  • The findings also indicated that some activities carry a greater risk of knee damage over time.

“This study and previous studies by our group suggest that high-impact, weight-bearing physical activity, such as running and jumping, may be worse for cartilage health.”

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“Conversely, low-impact activities, such as swimming and cycling, may protect diseased cartilage and prevent healthy cartilage from developing disease.”

Their Conclusion

The researchers concluded that there is a need for prospective studies to evaluate the influence of low-impact versus high-impact physical activity on disease progression.

My Conclusion(s)

  • Our bodies wear down with use. This should not come as a surprise to anyone 40+ years of age. Odds are there are lots of things that you can’t do that you could do in your teens or twenties. (see Viagra)
  • With age comes wisdom. Or at least it’s supposed to. As a kid, I never included a warm-up into my workout. Nothing hurt, so why would I warm-up? Today, if I skip the warm-up, things hurt.
  • Additionally, since I have become a slightly-older, slightly wiser version of myself, I have eliminated or modified the types of exercise that cause me pain – long distance running, 1 leg pistol squats, football, various weightlifting exercises, high intensity plyometric jumps, etc…

And with these modifications, I eliminated the nagging knee & shoulder pains that had begun to crop up.

My Other Conclusion(s)

  • shoulder painNo exercise is perfect for every person. Swimmers often suffer with shoulder pain. Cyclists often develop muscle imbalances due to their posture while cycling. Yoginis suffer joint injuries.
  • The body you have today is different from the body you had 20 years ago. Treat it as such.
  • Your body is different from my body. What works for me might not work as well for you.
  • Your body will tell you what is best for it. If your knees swell up after going for a long jog…maybe you shouldn’t go for a long jog. If your shoulders hurt after a set of overhead presses, maybe you should find a way to modify or replace that exercise.
  • There is a difference between high intensity exercises performed properly & high intensity exercises performed improperly.
  • Before giving up on “high intensity” exercises that require running & jumping, see if you can find a better way to do them. Try to modify before you eliminate.
  • Look at correcting postural imbalances that may lead to injuries
  • Consider purchasing rehabilitation equipment designed to prevent injuries

and most importantly, remember this…

You would rather visit an orthopedist than a cardiologist……so get off your butt and get some exercise.

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Exercise easier with a cuppa joe

April 2nd, 2009

coffee-you-can-sleep-when-youre-dead

For decades, endurance athletes have relied on caffeine as a performance aid.

They claimed that a pre-workout cup of coffee helped them to push themselves harder and for longer periods of time.

And along the way, science has backed up that belief:

  • In 1979, scientists found that caffeine helped cyclists improve their performance by 7% during a 2 hour workout.
  • In 1991, cyclists dosed with 9mg of caffeine per kg of bodyweight were able to increase their endurance by 51%
  • In 1995, cyclists performing high intensity circuits were able to improve their endurance by 29% with a dose of 5.5mg of caffeine per kg of body mass.

Pretty good, right?

The only problem is that no one really knew why caffeine improved athletic performance…until now.

Researcher (and cycling geek) Dr. Robert Motl has spent the last 7 years considering the relationship between physical activity and caffeine.

Today, he has a much better understanding of why that cuppa Joe he used to consume before distance training and competing enhanced his cycling ability.

Early in his research, he became aware that “caffeine works on the adenosine neuromodulatory system in the brain and spinal cord, and this system is heavily involved in nociception and pain processing.”

Since Motl knew caffeine blocks adenosine from working, he speculated that it could reduce pain.

A number of studies by Dr. Motl support that conclusion, including investigations considering such variables as exercise intensity, dose of caffeine, anxiety sensitivity and gender.

The good doctors latest study “looks at the effects of caffeine on muscle pain during high-intensity exercise as a function of habitual caffeine use,” he said. “No one has examined that before”.

And what did they find?

  • Caffeine reduces pain during exercise.

  • Less pain means you can work harder.

  • Less pain means you can work longer.

The Science

The study’s 25 participants were fit, college-aged males divided into two distinct groups:

  1. Subjects whose everyday caffeine consumption was extremely low to non-existent,
  2. And those with an average caffeine intake of about 400 milligrams a day, the equivalent of three to four cups of coffee.

After testing their baseline aerobic fitness, Dr. Motl tortured his subjects with two monitored high-intensity, 30-minute exercise sessions.

An hour prior to each session, cyclists – who had been instructed not to consume caffeine during the prior 24-hour period – were given a pill.

On one occasion, it contained a dose of caffeine measuring 5 milligrams per kilogram of body weight (equivalent to two to three cups of coffee); the other time, they received a placebo.

During both exercise periods, subjects’ perceptions of quadriceps muscle pain was recorded at regular intervals, along with data on oxygen consumption, heart rate and work rate.

The Results

Obviously the most important result was that caffeine reduced the pain of intense physical activity.

But Dr. Motl also found that when it came to the reduction of pain, “caffeine tolerance doesn’t matter”.

Caffeine-junkies and the herbal tea drinkers received the same pain reducing benefit from their little caffeine pill.

So, what now?

Dr. Motl wants to see what effect caffeine’s pain-reducing abilities has on sport performance.

“We’ve shown that caffeine reduces pain reliably, consistently during cycling, across different intensities, across different people, different characteristics.

But does that reduction in pain translate into an improvement in sport performance?”

Interesting question for sure, but I am way to impatient to wait for the next Dr. Motl study.

If you’re like me, check out this list of caffeine based beverages and let’s get physical.

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Fibromyalgia: A New Test Leads To A Cause And Maybe A Cure

November 3rd, 2008

For years and years and years and years, people suffering with fibromyalgia have faced a battle on two fronts.

  1. They battle chronic pain and all of the associated physical, mental and emotional problems that come with chronic pain.
  2. They fight a public and medical perception that fibromyalgia is not a real medical condition. That the pain is all in their heads.

A new study, published in the November issue of the Journal of Nuclear Medicine, may help fibromyalgia patients on both battle fronts.

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The Study

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Using single photon emission computed tomography (SPECT), researchers in France were able to detect functional abnormalities in certain regions in the brains of patients diagnosed with fibromyalgia, reinforcing the idea that symptoms of the disorder are related to a dysfunction in those parts of the brain where pain is processed.

“Fibromyalgia is frequently considered an ‘invisible syndrome’ since musculoskeletal imaging is negative,” said Eric Guedj, M.D., and lead author of the study. “Past imaging studies of patients with the syndrome, however, have shown above-normal cerebral blood flow (brain perfusion) in some areas of the brain and below-normal in other areas. After performing whole-brain scans on the participants, we used a statistical analysis to study the relationship between functional activity in even the smallest area of the brain and various parameters related to pain, disability and anxiety/depression.”

In the study, 20 women diagnosed with fibromyalgia and 10 healthy women as a control group responded to questionnaires to determine levels of pain, disability, anxiety and depression. SPECT was then performed, and positive and negative correlations were determined.

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The Results

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The researchers confirmed that patients with the syndrome exhibited brain perfusion abnormalities in comparison to the healthy subjects.

Further, these abnormalities were found to be directly correlated with the severity of the disease.

An increase in perfusion (hyperperfusion or excessive blood supply) was found in that region of the brain known to discriminate pain intensity, and a decrease (hypoperfusion or inadequate blood supply) was found within those areas thought to be involved in emotional responses to pain.

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Conclusions

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In the past, some researchers have thought that the pain reported by fibromyalgia patients was the result of depression rather than symptoms of a disorder. This study strongly refutes that belief.

According to the lead researcher, “Interestingly, we found that these functional abnormalities were independent of anxiety and depression status.”

This study also gives researchers a diagnostic tool to help predict a fibro patient’s response to a specific treatment and evaluate brain-processing recovery during follow-up.

“Fibromyalgia may be related to a global dysfunction of cerebral pain-processing,” Guedj added.

“This study demonstrates that these patients exhibit modifications of brain perfusion not found in healthy subjects and reinforces the idea that fibromyalgia is a ‘real disease/disorder.‘”

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What This Means For Fibromyalgia Patients

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This research does 3 important things for fibromyalgia patients:

  1. It gives legitimacy to their condition. No longer will family doctors, friends, family, employers, etc.. be able to tell fibro sufferers that their pain is not real, that it’s all in their heads.
  2. It gives researchers a tool to test treatment modalities.
  3. And now that they ‘know’ which areas of the brain are affected and how they are affected, they should be able to chart out a more direct route to a cure…or at least a treatment.

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Say Goodbye To Lower Back Pain with Band Training

October 6th, 2008

An effective way to prevent lower back pain is to stretch and strengthen all of the muscles in the lower back and core region.

One of the best ways to accomplish both of these modalities is with band training.

Here are a couple of videos from Dick Hartzell, the founder of Jump Stretch.

Dick has been at this for years. His training methods may seem a little unorthodox at first. But that’s okay. because they work.

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Lower Back Stretch & Strengthen

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Lower back Traction

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Exercise is Effective for Fibromyalgia Pain Relief

May 10th, 2008

A few years ago, I had the pleasure to work with a very nice lady who was trying desperately to reduce the painful effects of fibromyalgia. She had been suffering for years as a result of this painful and debilitating condition.

Like most chronic pain conditions, the worst thing may not even be the pain itself. It is the effect that the pain has on the rest of your life. In my client’s case, she spent the first year of her daughter’s life in bed. Every day. Unable to care for her newborn child.

When I met her, she was in better shape. Her daughter was older. She participated in her daughter’s life. She had a challenging career. She was happy. But she was still in constant pain.

She came to me after having quite a few bad experiences with different forms of physical and exercise therapy. At the time, I was working at a fitness club. She was initially assigned to work with a young, female trainer. Her choice.

It didn’t go well. The female trainer, who was a good trainer, knew little about fibromyalgia. During their first workout, she treated her client like a normal, PAIN FREE person. Bad move.

A week later, our fibromyalgia lady returned and demanded her money back. She had spent the last week in bed, popping pills and regretting ever coming into our gym.

I don’t know how, but the owner of the club managed to calm her down and have her agree to sit down and talk with me.

At this point, I knew very little about fibromyalgia. I did, however, know how to talk, or rather listen to justifiably angry women. Yes, I am married.

We discussed her condition. I gave her my opinion and told her that I would spend the next few days researching the subject. A few days later, we met and talked again. I discussed my findings and outlined what my plan for her fitness training would include. After about half an hour, we began our workout.

It was very slow at the beginning, but after about 3 months, everything began to change. Her body changed. She was catching up and blowing by some of my pain-free clients. More importantly, her day to day life improved drastically.

For those of you out there who know someone like my former client, please show them the following research paper, along with my story and do what you have to do to get them moving. They will thank you for it. Not right away…right away they might not be too pleased…but eventually..they will thank you.

Group Exercise, Education, and Combination Self-management in Women With Fibromyalgia

A Randomized Trial

Daniel S. Rooks, ScD; Shiva Gautam, PhD; Matthew Romeling, BS; Martha L. Cross, BS; Diana Stratigakis, BA; Brittany Evans, BS; Don L. Goldenberg, MD; Maura D. Iversen, DPT, SD, MPH; Jeffrey N. Katz, MD, MS

Arch Intern Med. 2007;167(20):2192-2200.

Background Self-management has increasingly been recommended as part of standard care for fibromyalgia, a common, poorly understood condition with limited treatment options. Data that assess popular self-management recommendations are scarce. We evaluated and compared the effectiveness of 4 common self-management treatments on function, symptoms, and self-efficacy in women with fibromyalgia.

Methods A total of 207 women with confirmed fibromyalgia were recruited from September 16, 2002, through November 30, 2004, and randomly assigned to 16 weeks of (1) aerobic and flexibility exercise (AE); (2) strength training, aerobic, and flexibility exercise (ST); (3) the Fibromyalgia Self-Help Course (FSHC); or (4) a combination of ST and FSHC (ST-FSHC). The primary outcome was change in physical function from baseline to completion of the intervention. Secondary outcomes included social and emotional function, symptoms, and self-efficacy.

Results Improvements in the mean Fibromyalgia Impact Questionnaire score in the 4 groups were –12.7 for the ST-FSHC group, –8.2 for the AE group, –6.6 for the ST group, and –0.3 for the FSHC group. The ST-FSHC group demonstrated greater improvement than the FSHC group (mean difference, –12.4; 95% confidence interval [CI], –23.1 to –1.7). The ST-FSHC (mean difference, 13.6; 95% CI, 2.3 to 24.9) and AE (mean difference, 13.1; 95% CI, 1.6 to 25.6) groups had similar improvements in physical function scores on the 36-Item Short-Form Health Survey. Bodily pain scores on the 36-Item Short-Form Health Survey improved in the ST-FSHC (14.8), AE (13.2), and ST (5.7) groups. Social function, mental health, fatigue, depression, and self-efficacy also improved. The beneficial effect on physical function of exercise alone and in combination with education persisted at 6 months.

Conclusions Progressive walking, simple strength training movements, and stretching activities improve functional status, key symptoms, and self-efficacy in women with fibromyalgia actively being treated with medication. The benefits of exercise are enhanced when combined with targeted self-management education. Our findings suggest that appropriate exercise and patient education be included in the treatment of fibromyalgia.

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Structural Balance

April 14th, 2008

In my last post, The Components of Physical Fitness, I broke down physical fitness into it’s component parts and provided a brief introduction of each part.

In today’s post, I will investigate in further detail one of those components: Structural Balance

Last time, I said that this structural balance deals with the alignment and interplay of your skeleton, skeletal muscles, ligaments, tendons & fascia.

For example, are your hamstrings too tight? Is your pelvis in proper alignment? Is the fascia covering your diaphram too tight?

If your body is out of alignment in one place, there will be adaptations elsewhere. Whether those adaptations will result in pain and injury depends on factors that are largely out of your control.

Before I begin to look at this topic in more detail, I have to admit that of all of the aspects of physical fitness, this is without a doubt NOT my area of expertise.

That is why I always say that before beginning a new fitness program, it might be a good idea to visit some form of physical therapist or an osteopath for an analysis of your structural balance.

If that is not an option, the following set of links will guide you towards the collected knowledge of some of the BEST experts on physical fitness as it pertains to your structural balance.

Vern Gambetta

Eric Cressey

Mike Boyle

Ken Kinakin

Mike Robertson

Gray Cook – Athletic Body in Balance

Each of these individuals have a unique approach to putting your body into balance. If it is possible to meet with one of them for an assessment, I would highly recommend it. If not, read some of their articles, decide which of their styles makes the most sense to you and apply ONE concept. Don’t try to do everything at once.

Before trying to correct any postural flaws, you should take a few digital photos of your posture – standing & sitting, from the front, rear and both sides. Lift your arms overhead, squat, etc… You would be surprised how easy it is to see your own flaws in a photo.

Most likely, this is what you are going to see.

This example was taken from

Neanderthal No More III
The complete guide to fixing your caveman posture!

Side View:

Client exhibits classic exaggeration of the double S-curve posture.

Forward head posture and chin protraction are evident.

Rounded shoulders combined with an exaggerated kyphosis are apparent in the upper thoracic region.

Significant anterior pelvic tilt with a concomitant increase in lumbar lordosis is also evident in the lumbo-pelvic region.

Anterior weight bearing is difficult to determine due to the cropping of the photo, but still seems to be an issue of concern.

This all to common postural flow is described in the following graphic taken from part 2 in Cressey & Robertsons’s Neanderthal No More series.

While posture #1 is the ideal, #4 is all too common. Primarily caused by hours of sitting and staring at television and computer screens, posture #4 has become all too familiar. Think about it, an hour sitting in the car driving to work, sittiong for most of your 8+ hours at work, driving back home and then finally dropping down onto the couch to watch some ‘must-see” tv. All this adds up to poor posture, misalignment, and eventually pain and disfunction.

Okay, enough doom & gloom.

This can all be corrected. Start with the links listed above. Take it slow. Your poor posture wasn’t created in a day and it won’t be corrected in a day.

Good luck.

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