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New 'Physio Clinic' Q&A session (Read 173668 times)

HPclinic

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indeed, dr suggests benign cyst is the very likely option and that as no pain/impingement on finger function it should be fine to ignore it and that although noisy, the noise is not indicative of damage being caused.  Now to get used to the unsettling noise ...
Hi, Ganglions can come and go. They can become a problem if they get bigger. Ease back in to the climbing and see how things go.
regards
Matt

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Hello,

I've had these symptoms for over two years now: pain and ache in my right shoulder area, particularly my shoulder blade,  and weak grip in my ring finger and pinky in right hand. I have seen a number of specialists and they all seem to think it's the ulnar nerve, and that it came about due to a joint clicking habit. I notice that this arm fatigues much faster than my other during climbing. Can the ulnar nerve get trapped in the shoulder area?

Any help is greatly appreciated, Thanks.
Hi, the problem sounds more likely to be coming from higher up ie your neck. The cervical spine can refer in to the shoulder blade area and the weakness in your little and ring finger correlate to a lower neck issue. There can be many reasons for this. I would suggest you go and see a physio to analyse the reasons why this is persisting.
Regards
Matt

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Hi Steve

I'm certainly no spritely youth, am not particularly injured, but have just felt creaky in the fingers all of this year. Have had many finger injuries over the years and maybe the creakiness is just to be expected. there is no pain or discomfort when climbing or performing other activities. the only real change to my routine this year over previous has been religiously cold-water-treatmenting my hands each evening, but the creakiness preceeded the cold watering.

Any ideas, is this just to be expected as the body gets older?

Cheers

Roddy
Hi Roddy, I would recommend hot/warm water rather than cold and 'creakiness' could be either tendons or joint noise. Nothing to worry about except keep the hands moving and stretch out all your finger joints prior to climbing.
regards Matt

Thanks steve Matt, will try the warm stuff  :2thumbsup:

Bit of a long running one this, but thought i should give a little feedback.

I completely stopped the cold water treatment and get warm water treatment via doing the washing up and erm, washing generally.

when i stopped the cold water treatment, my fingers stopped feeling worse, but due to old tears etc. still felt very fudgy through the latter part of last year.

i started taping my ring finger A2s again (the cheaty restrictive way) at the start of this year and felt a bit better still, however, i have since changed something else that has made a bigger difference.

i had been taking ghlucosamine sulphate for a long time and was also pretty reliant on the old vitamin I on training days. I have completely stopped both and feel much better. i have also been using the compex to lengthen (or at least loosen off) my forearms regularly and can now boulder tape free and even half-crimped feels semi-solid. i can even play with the captains of crush again for the first time in 5 or so years, without it feeling like something is going to cut loose in my hand/finger/forearm.

Thanks for setting me down what ended up being a long and meandering post road to a more sensible path  :icon_beerchug:

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Hi, seldom post and not quite sure how this thread works.

Got to the lead wall quite a lot over the winter and managed to bump up grades from f6b/6b+ to f7a. Managed five so far and close to a 7a+ after one session. Do tiny tiny bit  of weights and inconsistent finger boarding but not regular as don't like to train before going out on the rock.

Have a recurrent issue-yesterday at the Gap in South Wales-warmed up 5+, 6a, 6a+ 6b and then got on a vertical power endurance 7a putting in the clips. On first redpoint within three or four moves got burning sensation in forearm and forearm contracts strongly up-it does not feel like I have any control over it and it takes effort to bring it back to straight, needless to say it is the end of climbing for the day, this is not the first time this has happened. There is no residual pain once I stop but once it has happened it feels like it could go again at any point in that session.

In my mind it started two or three years ago on a steep 6b+ in Kalymnos when I was wearing a long sleeved top rolled half way up my forearms perhaps a bit too tight-not sure if I could have crushed something-may not be connected but it is frustrating when other things are going so well.

Symptoms are so specific I am not sure how to search for it at the minute.

So any ideas?

Thanks in advance

Rich

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Just spent 45 minutes writing up and it failed to post! Devastating. Here it is again:

Hi guys,

4 weeks ago I was in Whistler on holiday and I gave downhill biking a go for 3 days. After every run my back 3 fingers were moulded tightly around the handlebars and it was painful to uncurl them. I knew this was because I was squeezing the handlbars hard and tried to release a little when I could. I also thought the soreness was temporary and likely because I was trying out an activity I wasn't used to. After a week of rest only my little fingers remained sore and it seemed like my hands were healing.

Unfortunately, it's been another 3 weeks since and they've made little progress getting better. I've experienced almost every type of finger injury so far (tendons, pulleys, joints, ligaments, lumbricals, etc) and know what it feels like and what to do about it. This is like nothing I've experienced before - either that or I have a combination of the aforementioned injuries that is making it too difficult for me to isolate.

With both little fingers, if I pull on them in an open-handed position there is pain along the sides of the finger and from the DIP joint. When I pull on them in a crimped position the pain is a lot worse and comes once again from the sides of the finger and around mainly the DIP joint, which is felt on the underside. However, my left little finger is worse than my right and displays some mild swelling around the base of the finger and there is pain when I prod the inside of the MCP joint. I still have maximum mobility and can carry out day-to-day tasks without noticing either, with the exception of stretching the MCP joint such as when using my hands flat to push myself up from the floor/chair.

Thanks for any help or guidance.

Jack
(P.s. after my 2 visits to your practice the shoulder is more permanently up now with a bit of weighted shrug work and the pain on the inside of my elbow is diminishing at full lock as a result - thanks so much!)

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Sorry, in the above post it should say PIP joints in place of DIP joints.

HPclinic

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Hi, seldom post and not quite sure how this thread works.

Got to the lead wall quite a lot over the winter and managed to bump up grades from f6b/6b+ to f7a. Managed five so far and close to a 7a+ after one session. Do tiny tiny bit  of weights and inconsistent finger boarding but not regular as don't like to train before going out on the rock.

Have a recurrent issue-yesterday at the Gap in South Wales-warmed up 5+, 6a, 6a+ 6b and then got on a vertical power endurance 7a putting in the clips. On first redpoint within three or four moves got burning sensation in forearm and forearm contracts strongly up-it does not feel like I have any control over it and it takes effort to bring it back to straight, needless to say it is the end of climbing for the day, this is not the first time this has happened. There is no residual pain once I stop but once it has happened it feels like it could go again at any point in that session.

In my mind it started two or three years ago on a steep 6b+ in Kalymnos when I was wearing a long sleeved top rolled half way up my forearms perhaps a bit too tight-not sure if I could have crushed something-may not be connected but it is frustrating when other things are going so well.

Symptoms are so specific I am not sure how to search for it at the minute.

So any ideas?

Thanks in advance

Rich
Hi my apologies on the delayed response, as you can imagine it is holiday season.
It sounds like you are compressing a nerve in your forearm after you are pumped and getting a type of involuntary reaction. I have occasionally seen this in climbers and I would class it as compartment syndrome. Basically muscles can become overdeveloped or the fascia that separate the muscle compartments can become tight. When you exercise a muscle it will increase the blood flow to it and there will also be the by products of exercise, this in turn will increases the size of the muscle. If the compartment is tight the pressure will increase causing possible ischaemia (decreased blood flow) and compression of the nerve.
At this stage I would manage this by regular stretches of the wrist and fingers with elbow flexed and extended. After higher grades lift your arm above your head and move your wrist and fingers to aid drainage. You can also try regular self massage by going across the muscle belly (transverse) as opposed to along the muscle. This may also help if you get these involuntary actions.
Try and monitor when it occurs and back off the intensity. Perhaps have more regular rests and have easier days ie avoid cumulative loading.
see how you go and let me know if this helps, otherwise come and see us or a physio nearby.
regards
Matt

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Just spent 45 minutes writing up and it failed to post! Devastating. Here it is again:

Hi guys,

4 weeks ago I was in Whistler on holiday and I gave downhill biking a go for 3 days. After every run my back 3 fingers were moulded tightly around the handlebars and it was painful to uncurl them. I knew this was because I was squeezing the handlbars hard and tried to release a little when I could. I also thought the soreness was temporary and likely because I was trying out an activity I wasn't used to. After a week of rest only my little fingers remained sore and it seemed like my hands were healing.

Unfortunately, it's been another 3 weeks since and they've made little progress getting better. I've experienced almost every type of finger injury so far (tendons, pulleys, joints, ligaments, lumbricals, etc) and know what it feels like and what to do about it. This is like nothing I've experienced before - either that or I have a combination of the aforementioned injuries that is making it too difficult for me to isolate.

With both little fingers, if I pull on them in an open-handed position there is pain along the sides of the finger and from the DIP joint. When I pull on them in a crimped position the pain is a lot worse and comes once again from the sides of the finger and around mainly the DIP joint, which is felt on the underside. However, my left little finger is worse than my right and displays some mild swelling around the base of the finger and there is pain when I prod the inside of the MCP joint. I still have maximum mobility and can carry out day-to-day tasks without noticing either, with the exception of stretching the MCP joint such as when using my hands flat to push myself up from the floor/chair.

Thanks for any help or guidance.

Jack
(P.s. after my 2 visits to your practice the shoulder is more permanently up now with a bit of weighted shrug work and the pain on the inside of my elbow is diminishing at full lock as a result - thanks so much!)
Hi Jack, it sounds like a tendon type injury/cumulative strain. When mtbing off mountains there is an awful lot of braking (mainly with the first couple of fingers and occasionally all) and gripping. The loading is different to climbing and more sustained ie you are not getting a rest in between holds as in climbing. The finger joints can also become uncomfortable due to the sustained compression and gripping. Make sure you can fully extend all your finger joints with your wrist extended and your elbow straight. If not stretch them out even if it is uncomfortable. Try some local massage after putting your hands into some warm/hot water.
I would continue to climb but back off the grades and increase as able.
Alternatively if it is not settling then pop in for a better look.
regards
Matt

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Cheers for your reply, helpful and food for thought.

Further to my original post and with a bit more thought I realise that it seldom (never) happens at the start of the day, it occurs after a reasonable amount of exertion  so perhaps I can head it off by pacing myself and not rushing through a bunch of warm ups and doing what you suggest in between.

Have not had it the last few sessions which perhaps means I am not pulling hard enough-seems to come and go like that, ie it will happen every session for a while and then stop for a while-always coming back though.

many thanks

Rich

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Hi guys,

Just got back from a 3 week trip and I've got a really tender spot in my palm, just where the crease is 2cm below the little finger is. Any ideas what it might be? It doesn't really hurt except for when I poke it.

Cheers,

Dave

HPclinic

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#310 Re: New 'Physio Clinic' Q&A session
August 01, 2014, 03:01:32 pm
Hi guys,

Just got back from a 3 week trip and I've got a really tender spot in my palm, just where the crease is 2cm below the little finger is. Any ideas what it might be? It doesn't really hurt except for when I poke it.

Cheers,

Dave
Hi Dave, the metatarsal-phalangeal joint is under this crease and it may be sore from excessive loading and climbing (cumulative strain from daily climbing). If you have been doing a lot more climbing than usual then you might need to back off the grades over the next week or two to allow some recovery. If it were a tendon issue then I think it would be more painful when climbing.
keep the fingers moving and let me know how things go.
regards
Matt

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#311 Re: New 'Physio Clinic' Q&A session
August 22, 2014, 08:01:29 am
Hi

I got back from a bouldering trip to Font a week ago. I've had a sore shoulder since leaving. I didn't fall and nothing unusual happend whilst climbing. I can can lift my arm forwards, back and up with no issue. If I try to lift my arm out to the side it hurts my shoulder once my hand is at waist height. I'm guessing rotator cuff? I'm not sure how long I should rest for? I found some exercises to do but I'm not sure how hard to push them? If at all.
Any help much appreciated
Cheers
Matt

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#312 Re: New 'Physio Clinic' Q&A session
August 22, 2014, 01:29:12 pm
Hi

I got back from a bouldering trip to Font a week ago. I've had a sore shoulder since leaving. I didn't fall and nothing unusual happend whilst climbing. I can can lift my arm forwards, back and up with no issue. If I try to lift my arm out to the side it hurts my shoulder once my hand is at waist height. I'm guessing rotator cuff? I'm not sure how long I should rest for? I found some exercises to do but I'm not sure how hard to push them? If at all.
Any help much appreciated
Cheers
Matt
Hi Matt, I would imagine you have had more of an intense week of climbing when you have been away. It sounds more cumulative than anything specific (as you have mentioned).
It might be that you have had a mild strain of the rotator cuff and this has affected the way you move your shoulder ie you may be getting a mild impingement. This is commonly felt when taking the arm out to the side.
I would suggest backing off the grades over the next two weeks (enough to be climbing relatively pain free) and slowly increase the volume and intensity as the symptoms allow.
If symptoms are not settling down then go and see a physio before you develop any compensations.
regards
Matt

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#313 Re: New 'Physio Clinic' Q&A session
August 28, 2014, 08:34:01 pm
Hi

I was wondering if there are any exercises you could suggest to recover plantar flexion range of the ankle. I'm a good 15/20 degrees short on the right ankle ever since i broke it a year ago, and the Physio i was seeing wouldn't help me out as according to him i don't need to be able to fully extend my foot  :furious:

Google not been too helpful either. Are there any type of stretches or something that would actually help to recover those extra couple of inches? I'm already a bit of a short arse, so that extra range is pretty valuable to reach holds and the extra springiness in the more dynamic moves would be handy.

Thanks a lot   

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#314 Re: New 'Physio Clinic' Q&A session
August 28, 2014, 10:20:40 pm
Sit on your heels?

Reduce the padding under your shins/ankles as you regain flexibility.


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#315 Re: New 'Physio Clinic' Q&A session
August 29, 2014, 09:18:19 am
Hi Matt

I have a tender spot in/around my Trapezius on the right side and also quite stiff around the neck and shoulders. It looks like there's a slight swelling you can see in the picture.
I rested a few days then reduced the intensity of my sessions and have been doing neck stretches and shrugs, also tried using a tennis ball for massage but quite unsuccessfully. 

What would you recommend to get this sorted out?

Thanks

Ian


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#316 Re: New 'Physio Clinic' Q&A session
August 29, 2014, 01:25:39 pm
Hi

I was wondering if there are any exercises you could suggest to recover plantar flexion range of the ankle. I'm a good 15/20 degrees short on the right ankle ever since i broke it a year ago, and the Physio i was seeing wouldn't help me out as according to him i don't need to be able to fully extend my foot  :furious:

Google not been too helpful either. Are there any type of stretches or something that would actually help to recover those extra couple of inches? I'm already a bit of a short arse, so that extra range is pretty valuable to reach holds and the extra springiness in the more dynamic moves would be handy.

Thanks a lot
Hi, the exercise/stretch that Duncan has suggested is a good one. Just make sure you don't compensate by rotating your foot.
 A year on post fracture can be difficult to change. I would also look at what your calf raises are like and dynamic movements such as hopping. Compare to your good leg. What did you fracture ?Also maybe get a second opinion from another physio?
let me know how it is going and any further info. may help me.
regards
matt

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#317 Re: New 'Physio Clinic' Q&A session
August 29, 2014, 01:35:28 pm
Hi Matt

I have a tender spot in/around my Trapezius on the right side and also quite stiff around the neck and shoulders. It looks like there's a slight swelling you can see in the picture.
I rested a few days then reduced the intensity of my sessions and have been doing neck stretches and shrugs, also tried using a tennis ball for massage but quite unsuccessfully. 

What would you recommend to get this sorted out?

Thanks

Ian


Hi Ian, It is not common to have swelling in this area, it may be the muscle is slightly more prominent due to the general shoulder girdle position.
Your right shoulder looks slightly more depressed and protracted (forward) than your left.  This would tend to suggest your pects on the right are tighter ie pulling your shoulder forward. If your shoulder is slightly down then this makes it more mechanically weaker ie the muscles are not in there optimal position. I wouldn't over stretch the neck on the right side because in theory you are slightly stretching these structures already.
Try shoulder presses and exercises to elevate the shoulder and if you are doing any other shoulder exercises try and lift the shoulder slighgtly but don't pull it back too much. If symptoms are persisting I would recommend a consultation as it would be good to observe you moving as this may be causing the discomfort.
Working postures are also important to look at as you may be dropping the shoulder when using a mouse for example.
regards
Matt   

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#318 Re: New 'Physio Clinic' Q&A session
September 05, 2014, 12:15:03 pm
Thanks Duncan and Matt, i'll be giving that a try.

Yes, it could be hard to get anything out of it a year on, but i may as well try. Since nothing has been done so far i reckon i should get at least a little improvement, or i hope so at least.

Fracture was a pilon + fibula which was effectively neglected for 2 months... and after that even though the doc sent an urgent referral for physio it still took a further 3 months for my first appointment to come through, only to end up with somebody fresh from school who said he didn't know what to do. So a further month to get re-referred to a second physio who gave up after 4 20 minute sessions saying that everything he would try i was already doing it by myself and there was no point in me going to see him any more. Got to love the NHS  :blink:

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#319 Re: New 'Physio Clinic' Q&A session
September 05, 2014, 01:00:05 pm
Thanks Duncan and Matt, i'll be giving that a try.

Yes, it could be hard to get anything out of it a year on, but i may as well try. Since nothing has been done so far i reckon i should get at least a little improvement, or i hope so at least.

Fracture was a pilon + fibula which was effectively neglected for 2 months... and after that even though the doc sent an urgent referral for physio it still took a further 3 months for my first appointment to come through, only to end up with somebody fresh from school who said he didn't know what to do. So a further month to get re-referred to a second physio who gave up after 4 20 minute sessions saying that everything he would try i was already doing it by myself and there was no point in me going to see him any more. Got to love the NHS  :blink:
Hi, no problems. The fracture you mention is a more complicated one than just the fibula. I am sorry you didn't receive treatment earlier. Keep stretching it and hopefully you will regain some more movement, and as I said test you calf raises and can you bounce on it?
regards
matt

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#320 Re: New 'Physio Clinic' Q&A session
September 05, 2014, 01:50:35 pm
The fracture you mention is a more complicated one than just the fibula.

Yes, the fibula was incidental, so much so that the latest doc said there was no need to heal it as according to him it has no use  :o Luckily it healed on its own, albeit in a rather funky configuration...

test you calf raises and can you bounce on it?

Calf raises barely. I can just about push on the toes and get the heel off the ground a little over an inch doing a single calf raise. Getting pretty strong with static strength though thanks to climbing.

  Bouncing no way as the calve is still not strong enough to 'launch' me and definitely not even close to cushion the landing through the ball of the foot if you know what i mean. Still going down stairs landing on the heel...

 Work in progress that is, but according to the physio since the muscle doesn't travel much then it won't strengthen either? Think he was talking out his ass though, as i'm definitely seeing improvements on that and with a bit of momentum i can feel the push when lightly skipping or trying to 'run' up stairs which it wasn't happening some weeks ago.

Thanks

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#321 Re: New 'Physio Clinic' Q&A session
September 12, 2014, 12:30:07 pm
The fracture you mention is a more complicated one than just the fibula.

Yes, the fibula was incidental, so much so that the latest doc said there was no need to heal it as according to him it has no use  :o Luckily it healed on its own, albeit in a rather funky configuration...

test you calf raises and can you bounce on it?

Calf raises barely. I can just about push on the toes and get the heel off the ground a little over an inch doing a single calf raise. Getting pretty strong with static strength though thanks to climbing.

  Bouncing no way as the calve is still not strong enough to 'launch' me and definitely not even close to cushion the landing through the ball of the foot if you know what i mean. Still going down stairs landing on the heel...

 Work in progress that is, but according to the physio since the muscle doesn't travel much then it won't strengthen either? Think he was talking out his ass though, as i'm definitely seeing improvements on that and with a bit of momentum i can feel the push when lightly skipping or trying to 'run' up stairs which it wasn't happening some weeks ago.

Thanks
Hi, it sounds like it is changing and definitely keep going. In theory your calf will strengthen and also the bounce will return and start to control your foot. Sometimes it can feel strong but it can still take time to be able to hop and then reabsorb the energy on landing for the next hop. Patients often report that their ankle feels wooden.   Try leaning forward on to a kitchen worktop and do little supported bounces from the left to right foot (both single and double small bounces). You might find this is a start as you can't hop unsupported.
Using your body weight is probably the best way to self mobilise that tight scar tissue as it tends to be hard work when trying to stretch it with your hands.
Let me know how your are going.
Regards
Matt

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#322 Re: New 'Physio Clinic' Q&A session
October 07, 2014, 07:11:43 pm
Hello HP Clinic.

I have a recently acquired problem I was hoping you could possibly advise me on. I have started with some discomfort in my left elbow. I've never had any trouble with it before. I've had a niggling pain in it, certainly worse when my arm is fully bent. I do a physical job which isn't helping but being self employed, no one pays you for being off ill though. Climbing wise it's been slowing me down, and tonight it reduced me to a stop. I just couldn't put any power through my arm at all and started peeling off problems, even easy stuff. The sore area is just up from my actual elbow joint, a few inches up my forearm. Sorry about the lack of specifics, quite hard to describe. Tonight it has also left me with pins and needles in my forearm and the back of my hand, which is a first. My training sensei has advised I treat it with ice and heat, and anti inflammatory if needed. Any other input at all? I have my first trip to font at the end of the month, so no pressure  :'(

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#323 Re: New 'Physio Clinic' Q&A session
October 09, 2014, 01:00:31 pm
Hi there Steve and gang,

Hoping you can help me out; as you have done in the past...

Whilst climbing on Tuesday I was doing a move where was hanging by my arms and trying to lift my feet up to a foot hold very high up and to my left. So I basically doing an awkward knee lift and twist, which I must admit didn't feel plausible, but I was just trying to stay on the route!

My attempt ended with a sharp pain on the right side of the front of my torso at the bottom of my ribs and was accompanied by snappy noise.

The pain now comes when moving around in bed, looking over left shoulder (reversing!) and various other things where I engage my right hand side upper body. As I write this I am less than 48hrs in so might be jumping the gun a bit as I imagine that a period of healing might just sort it out. But because of that unpleasant noise at the point of the injury I thought I would try to get some understanding of what I might have done to myself!

Any ideas?

Many thanks for any help.

Richard W

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#324 Re: New 'Physio Clinic' Q&A session
October 09, 2014, 04:22:58 pm
...

oh and I forgot to say, it also hurts if I sneeze, laugh or take a deep breath.  :(

Richard.

 

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