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Shoulder Impingement Health Feed

Shoulder Impingement - What Causes It?

Dr.Navin Sahu 85% (34ratings)
MBBS, Diploma in Orthopaedics, M.Ch - Orthopaedics
Orthopedic Doctor, Gurgaon
Shoulder Impingement - What Causes It?

Shoulder impingement syndrome is a condition of the shoulder that is characterized by a feeling of pain and weakness while lifting the arm overhead. A tendon, known as the rotator cuff tendon, attaches the tip of the upper arm to the shoulder. Impingement of the shoulder occurs when this tendon is trapped in the sub acromial space. The sub acromial space is the space near the shoulder joint where the tendon goes through.
When the tendon is trapped, it tends to scrape against the bone, resulting in excruciating pain. The pain aggravates if you are performing overhead movements such as painting or swimming.

The symptoms of shoulder impingement syndrome are:

  1. Feeling of pain while lifting the arm overhead
  2. Any lateral raising movement may also cause pain
  3. Sleeping at night may be problematic as lying on one side of the body may cause pain
  4. Clicking sounds while performing exercises such as the overhead press

Shoulder impingement syndrome can be caused by a number of factors; some of them are:

  1. Swelling of the rotator cuff: The rotator cuff tendon may swell on account of a shoulder injury.
  2. Bone spurs: If there are bone spurs in the sub acromial space, then it may narrow down the space making it easier for the tendon to rub against the bone.
  3. Accumulation of calciumIn some cases, calcium deposits tend to accumulate in the rotator cuff tendon leading to shoulder impingement.
  4. Inflammation of the bursa: The bursa is a sac filled with fluid cushions bones; inflammation of the bursa may also result in shoulder impingement

If you are suffering from a shoulder impingement syndrome, you may adopt the following strategies to deal with it:

  1. Rest: Make sure you do not perform activities that could aggravate the pain; allow the affected area to rest so that it heals faster.
  2. Medications: Medicines such as NSAIDs help in reducing the pain to provide temporary relief.
  3. Exercise: Adopt various external rotation exercises to strengthen the rotator cuff tendon and prevent shoulder impingement syndrome.
2473 people found this helpful

Shoulder Pain - What Are The Various Causes Of It?

MBBS, MS - Orthopaedics
Orthopedic Doctor, Ranchi
Shoulder Pain - What Are The Various Causes Of It?

Your shoulder is one of the most overused joints in the body and thus is at a higher risk of contracting an injury. Shoulder pain may lead to mobility issues where moving your arms may become extremely difficult. The shoulder consists of three parts, viz. the shoulder blade, collarbone and the upper arm bone. Shoulder pain may result from an injury to any of these areas.

The various causes of shoulder pain are:

  1. Impingement: Impingement of the shoulder muscle occurs when the top of the shoulder impinges on the rotator cuff muscles. This condition can lead to severe pain in the shoulder.
  2. Bursitis: Bursa is a fluid filled sac that cushions the bones and help in preventing friction. Bursitis is a disorder that results in inflammation of the bursa, thus resulting in shoulder pain.
  3. Tendinitis: Tendinitis is a condition that is characterized by gradual wear and tear of the tendon. Usually the rotator cuff tendons in the shoulder are affected by this condition.
  4. Instability of the shoulder: Shoulder instability is a disorder of the shoulder wherein the upper arm bone dislocates from its socket. This can cause excessive pain in the shoulder.
  5. Fractures: A fracture in the bones of the shoulder results in excruciating shoulder pain.
  6. Arthritis: Arthritis is a disorder that leads to inflammation in the joints, thus resulting in pain and impaired movement of the joint.

Treatment

The treatment for shoulder pain consists of medications and physiotherapy. You may also be asked to discontinue any strenuous activity that requires shoulder movement. Medications such as NSAIDs are prescribed to help in controlling the pain. Various stretches of the shoulder are also recommended to improve shoulder flexibility and mobility.

Tips

Do exercises such as the overhead press with light weights to improve your shoulder strength. Also make sure to include certain external rotation exercises to strengthen the rotator cuff muscles.

4304 people found this helpful

Subacromial Impingement - Know Signs Of It!

MBBS, MS - Orthopaedics
Orthopedic Doctor, Mohali
Subacromial Impingement - Know Signs Of It!

Subacromial impingement is a very common problem relating to the shoulder area, accounting for almost 50% of the shoulder pain complaints. It is a very small space covered by bones on all spaces, and in fact, only when there is inflammation in this area does space become evident on radiographs. There are various tendons and muscles, which work together to allow for shoulder movement upwards and downwards and front and the back. With repeated movements, these tendons get impinged or pinched and so cause limited motion, pain, swelling, instability, etc.

This injury is very common in people who use the shoulder repeatedly and in similar movements, especially with sportspersons like basketball, swimmers, etc. Non-sportspeople like painters and construction workers can also sustain this injury, given the repetitive motion of the shoulder joint.

What causes subacromial impingement?

  1. Irritation and impingement of the shoulder joint due to repeated motion
  2. Acute injury or accident involving the shoulder
  3. A poor posture where shoulders are constantly in a stooped position
  4. Shoulder instability

If a person has subacromial impingement, the symptoms will include:

  1. Pain in lifting shoulder to the front and above the head
  2. Weakness in the shoulder with gradual loss of function
  3. Swelling and stiffness of the shoulder
  4. Night pain, especially with rolling the shoulder
  5. Limited movement
  6. Hemorrhage in advanced cases

As the condition progresses, the symptoms worsen and gradually can lead to calcifications in the tendon space and loss of shoulder strength. The impingement can go through 3 stages, with both age and symptoms increasing with each stage.

Diagnosis: A combination of history, clinical presentation, x-ray, and MRI are used in diagnosis. Specific tests like empty can are also useful in arriving at a diagnosis.

Management: Conservative measures like resting, ice and heat therapy, medications, and exercise are the first line of therapy. When the condition persists even after 3 to 4 months, then surgical intervention is required.

  1. Avoid activities which cause repetitive movement of the shoulder.
  2. Ice the area for 10 to 15 minutes every 4 to 6 hours through the day to reduce the inflammation.
  3. Compression also can be used which will help in pain control.
  4. Keep the shoulder elevated like in a sling to help in pain relief.
  5. Nonsteroidal anti-inflammatory medications can help control inflammation and pain, improve movement, and reduce swelling or stiffness.
  6. Exercise can be included in the daily routine as it improves shoulder strength and flexibility.
  7. Surgery is usually considered the last resort. It is only when all the conservative measures fail, surgery is advised.
2534 people found this helpful

Shoulder Pain - What Can Cause It?

Dr.Darsh Goyal 89% (22ratings)
MS - Orthopaedics, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship in Joint Replacement, MCh (Ortho)
Orthopedic Doctor, Delhi
Shoulder Pain  - What Can Cause It?

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch/wash your back, comb your hair or reach your back pocket. Shoulder pain can happen due to various reasons, vary from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc.. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In the case of middle to old age, injuries that can cause shoulder pain are-

  • Biceps Tendonitis
  • Acromio-clavicular Joint arthritis
  • Scapular Dyskinesia
  • Trapezitis
  • Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
  • Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of the shoulder can cause shoulder pain due to...

  • Bankart lesion

Diagnose Shoulder Pain-

Shoulder pain can be diagnosed only after a thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

  1. X-rays: Through an x-ray one can view the shoulder in many different views
  2. Ultrasound: With ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
  3. MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
  4. Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain-

  1. For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
  2. Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions -

  1. Pain relief and physiotherapy as the first step If this fails then following surgical options are available
  2. Arthroscopic debridement or repair of labrum
  3. Biceps tenotomy or tenodesis

Arthritis -

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle-aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle is not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Remember "a stitch in time saves nine"

3675 people found this helpful

Shoulder Impingement - What Should You Know About It?

Dr.Shekhar Srivastav 86% (19ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, AO Fellowship
Orthopedic Doctor, Delhi
Shoulder Impingement - What Should You Know About It?

Shoulder impingement occurs when there is impingement or change in the position of the tendons or a bursa (fluid filled sac or cavity, which causes friction in the joints) in your shoulder. Repeated overhead exercises or intense physical activity concentrated around your shoulder is a common risk factor for shoulder impingement. The examples of such activity would include playing outdoor sports like tennis, swimming etc. or painting for long hours.

How it may affect your daily life?
Shoulder impingement pain is severe in many cases and may affect your everyday activities. In fact, any activity, which involves your shoulders can cause intense pain. You should consult a doctor or a professional medical facility to get relief from pain as well as to avoid aggravating the injury.

Symptoms of shoulder impingement:
1. You will have difficulty in completing tasks which involve your back.
2. There may be a weakness in your shoulder muscles.
3. Pain associated with overhead use of your arm. Anytime you lift your arm there would be pain and would make many day to day activities difficult.
4. Intense injury to the tendons can cause them to tear into two and would result in a rotator cuff injury and would make your arm movements next to impossible.

Diagnosis of shoulder impingement:
Physical exam and review of medical injury previously sustained on some other occasion is the first step of treatment. Your doctor may also diagnose shoulder impingement by X-rays or MRI of shoulder to see changes in the bone that may indicate any injury. Other changes in the normal contour of the bone may also be checked which may help in further diagnosis and treatment.

Treatment of shoulder impingement:

NSAIDs are anti-inflammatory medicines that are commonly prescribed for shoulder impingement syndrome. These are prescribed for two weeks. Shoulder impingement requires a long time to heal and would require regular consultation with your doctor. If the medications fail to provide any relief in a span of maximum two weeks it may compel your doctor to change the course of treatment. Shoulder impingement is a serious injury and requires proper rest for your shoulder as well as patience as it may take quite some time to come back to normal.

Physiotherapy for Impingement:

Physiotherapy is usually the first line of treatment for subacromial impingement (tendonitisbursitis) of the shoulder; along with anti-inflammatories and analgesia. It is very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

  1. Pain Management
  2. Manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly.
  3. You will learn exercises and stretches to help your shoulder and shoulder blade move properly.
  4. Strengthening Exercises
  5. The therapist will teach you the proper posture which is an important part of rehabilitation
4271 people found this helpful

Disabling Pain Shoulder - Can It be a Sign of Shoulder Impingement?

MBBS, Ph. D - Orthopaedics
Orthopedic Doctor, Bangalore
Disabling Pain Shoulder - Can It be a Sign of Shoulder Impingement?

Shoulder impingement is a serious condition leading to severe pain in the shoulder blades of a person. Such kind of shoulder pain may affect anybody anytime. It basically affects the area of your shoulder facing stress due to any sort of overhead action. An impactful pressure on the tendons of bones constituting your shoulder gives rise to this disorder. This syndrome can affect a person who paints, swims, lifts or plays tennis on a regular basis. Once caused, persistent rendering of similar activities can worsen the case. If you are suffering from shoulder impingement syndrome, treatment under an experienced medical practitioner is indeed necessary as otherwise, you may have to suffer from tendinitis or bursitis.

Take a keen look at the symptoms of shoulder impingement

  1. Disabling pain in and around the shoulders
  2. Under the effect of such excruciating pain, a person has restricted use of his or her arms and neck. He or she will face difficulties in reaching to a higher position above his or head. Aiming up behind your back will also be a challenge with the existence of this syndrome.
  3. There is considerable weakness in the muscles of your shoulders, preventing you from working with full vigor
  4. If left unattended, shoulder impingement can worsen to cause Rotator Cuff Tear where the tendons tear into two distinctive parts.

Available modes of treatment

  1. A doctor might prescribe you anti- inflammatory drugs to relieve you from excess pain. These drugs should only be taken under the close monitoring of a specialist as they might have acute side effects. You might feel nauseous or might have an upset stomach after consuming these medications.
  2. Stretching your arms above your head while holding your body in an erect posture can be of great help. This stretching exercise should be tried out in a warm shower for better results.
  3. Other exercises under the supervision of a physiotherapist can come to your rescue as well. You should try to move your thumb up your back to recuperate from shoulder impingement.
4422 people found this helpful

Shoulder Impingement - Must Know Things About It!

Dr.Vikas Gupta 86% (18ratings)
MBBS, MS - Orthopaedics, Hand Surgery Fellowship
Orthopedic Doctor, Delhi
Shoulder Impingement - Must Know Things About It!

Shoulder impingement occurs when there is impingement or change in the position of the tendons or a bursa (fluid filled sac or cavity, which causes friction in the joints) in your shoulder. Repeated overhead exercises or intense physical activity concentrated around your shoulder is a common risk factor for shoulder impingement. The examples of such activity would include playing outdoor sports like tennis, swimming etc. or painting for long hours.

How it may affect your daily life?
Shoulder impingement pain is severe in many cases and may affect your everyday activities. In fact, any activity, which involves your shoulders can cause intense pain. You should consult a doctor or a professional medical facility to get relief from pain as well as to avoid aggravating the injury.

Symptoms of shoulder impingement:
1. You will have difficulty in completing tasks which involve your back.
2. There may be a weakness in your shoulder muscles.
3. Pain associated with overhead use of your arm. Anytime you lift your arm there would be pain and would make many day to day activities difficult.
4. Intense injury to the tendons can cause them to tear into two and would result in a rotator cuff injury and would make your arm movements next to impossible.

Diagnosis of shoulder impingement:
Physical exam and review of medical injury previously sustained on some other occasion is the first step of treatment. Your doctor may also diagnose shoulder impingement by X-rays or MRI of shoulder to see changes in the bone that may indicate any injury. Other changes in the normal contour of the bone may also be checked which may help in further diagnosis and treatment.

Treatment of shoulder impingement:

NSAIDs are anti-inflammatory medicines that are commonly prescribed for shoulder impingement syndrome. These are prescribed for two weeks. Shoulder impingement requires a long time to heal and would require regular consultation with your doctor. If the medications fail to provide any relief in a span of maximum two weeks it may compel your doctor to change the course of treatment. Shoulder impingement is a serious injury and requires proper rest for your shoulder as well as patience as it may take quite some time to come back to normal.

Physiotherapy for Impingement:

Physiotherapy is usually the first line of treatment for subacromial impingement (tendonitisbursitis) of the shoulder; along with anti-inflammatories and analgesia. It is very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

  1. Pain Management
  2. Manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly.
  3. You will learn exercises and stretches to help your shoulder and shoulder blade move properly.
  4. Strengthening Exercises
  5. The therapist will teach you the proper posture which is an important part of rehabilitation
3958 people found this helpful

8 Exercises You Should Ignore To Safeguard Your Body!

Dr.Kiran Kumar Lakkampalli 90% (10ratings)
BPTh/BPT
Physiotherapist, Hyderabad
8 Exercises You Should Ignore To Safeguard Your Body!

People who regularly work out can go on about its benefits and also show off a toned physique. However, a bad or improper movement can be more harmful than no exercise at all. Read on to know some common exercises that are best avoided for their potential harmful effects. 

  1. Dumbbell punches (Punching the air with dumbbells in hands): By holding dumbbells and punching them forward into the air, you are just spending your energy for absolutely no benefit. It is good as a conditioning one if done for a long time but does not help the shoulders or the arms. Bicep curls and triceps extensions yield much better results than these punches.
  2. Shoulder Shrugs (Rolling shoulders with dumbbells in hands): The only muscle that gets worked here is the trapezius, which is at the joint of the shoulders and the neck. The arms and the back do not get any benefit and shoulder shrugs can actually cause postural problems and increase shoulder tension. It is best to avoid this exercise if you are not a professional bodybuilder.
  3. Thigh machines (Pressing weight through legs): One of the most ineffective machines in the gym is a thigh machine. The poor posture and no workout for the abs are few of the reasons why the outer and inner thigh workouts should be avoided. Better results can be achieved with squats and lunges, which also help more muscles and help in losing weight.
  4. Plank rows (Push-up posture & lifting hands one by one): Plank rows or board lines are almost ineffective for back and arm strengthening. Better results are achieved with the usual lines for these areas.
  5. Squatting on a Bosu ball (Squatting on a specific machine): This colourful equipment might be alluring but can be really dangerous and cause ankle and knee injuries. It can also result in meniscal tears or disruptions.
  6. Crunches (Laying on floor and pushing head upwards with hands): When improperly done, crunches produce the same position as one achieves while working on a computer - head forward and rounded shoulder. Crunches are meant to be done by pulling up on the head and not using the abs, as most people incorrectly do.
  7. Lat pull-downs behind the neck (Pulling down weight behind your back): This can be very harmful for people who have even minor shoulder joint problems. The idea is to build arm, torso, and back muscles by pulling a weighted bar down the front and back of the chest area. This can cause misalignment, shoulder impingement, or a tear in the rotator cuff, and in severe cases, even cervical vertebral fracture.
  8. Military Presses Behind the Head (Pulling up weight behind your back): Similar to a lat pull-down, here also, a barbell is lifted up and down behind the head and can cause the same problems as the earlier one, including fracture of the cervical spine.

Make sure you get a professional trainer's advice on the right ways to work out so as to get the maximum benefits and avoid injuries.
 

3863 people found this helpful

Causes and Symptoms of Subacromial Impingement

Dr.P. Sharat Kumar 88% (122ratings)
FFSEM, MFSEM, DIP - SEM GB & I, MCh - Orthopaedics, MS - Orthopaedics, MBBS
Orthopedic Doctor, Hyderabad
Causes and Symptoms of Subacromial Impingement

The rotator cuff is made up of four muscles and the tendons attached to them under the shoulder roof that lowers and raise the arm. Acromion is an extension of the shoulder blade. Subacromial bursa lies in the space between the acromion and the rotator cuff. Subacromial bursa is a sac filled with fluid that allows the rotator cuff beneath the acromion to glide smoothly when the shoulder is moved.

If the four tendons in the rotator cuff are injured, strained or a bone spur develops on the acromion, it can result in the swelling of tendons and also in the rubbing or pinching against the acromion as space between the tendons and acromion gets narrowed. The tendons get irritated when they pass through this acromial space. This is called subacromial impingement.

Subacromial impingement is also known as shoulder impingement syndrome, supraspinatus syndrome, painful arc syndrome, thrower's shoulder and swimmer's shoulder.
Repeated activity where the shoulders are moved overhead like in tennis, painting, swimming, lifting and abnormalities in bones and joints are the risk factors of subacromial impingement.

Causes:
The exact cause of impingement is not explicitly known.

  1. Tendon may split if there is continuous wear and tear
  2. It may be caused by minor injuries. However, this injury may be triggered by repeated overhead activities as well.
  3. Age is another cause. As one grows older, bone spurs may develop on the acromion. Also the tendons are prone to tearing after the age of 40.
  4. Sometimes the acromion shape can make people prone to subacromial impingement.

Symptoms:
Subacromial impingement presents itself with the following symptoms:

  1. Reaching above behind your back and reaching overhead with your arms gets difficult.
  2. Shoulder muscles weaken
  3. The tendons can actually tear in two if injuries persist for a considerable duration. This can result in rotator tear cuff. Elevating your arms gets very difficult.
  4. Bicep tears are common if impingement persists.
5360 people found this helpful

Shoulder Impingement - What Is The Right Way To Diagnose?

Dr.Shailesh Mishra 90% (41ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, DNB - Ortho, Fellowship In Knee Replacement & Arthroscopic Surgery ( Knee & Shoulder )
Orthopedic Doctor, Mumbai
Shoulder Impingement - What Is The Right Way To Diagnose?

Shoulder impingement occurs when there is impingement or change in the position of the tendons or a bursa (fluid filled sac or cavity, which causes friction in the joints) in your shoulder. Repeated overhead exercises or intense physical activity concentrated around your shoulder is a common risk factor for shoulder impingement. The examples of such activity would include playing outdoor sports like tennis, swimming etc. or painting for long hours.

How it may affect your daily life?
Shoulder impingement pain is severe in many cases and may affect your everyday activities. In fact, any activity, which involves your shoulders can cause intense pain. You should visit a doctor or a professional medical facility to get relief from pain as well as to avoid aggravating the injury.

Symptoms of shoulder impingement:

  • You will have difficulty in completing tasks which involve your back.
  • There may be a weakness in your shoulder muscles.
  • Pain associated with overhead use of your arm. Anytime you lift your arm there would be pain and would make many day to day activities difficult.
  • Intense injury to the tendons can cause them to tear into two and would result in a rotator cuff injury and would make your arm movements next to impossible.

Diagnosis of shoulder impingement:
Physical exam and review of medical injury previously sustained on some other occasion is the first step of treatment. Your doctor may also diagnose shoulder impingement by X-rays or MRI of shoulder to see changes in the bone that may indicate any injury. Other changes in the normal contour of the bone may also be checked which may help in further diagnosis and treatment.

Treatment of shoulder impingement:

NSAIDs are anti-inflammatory medicines that are commonly prescribed for shoulder impingement syndrome. These are prescribed for two weeks. Shoulder impingement requires a long time to heal and would require regular consultation with your doctor. If the medications fail to provide any relief in a span of maximum two weeks it may compel your doctor to change the course of treatment. Shoulder impingement is a serious injury and requires proper rest for your shoulder as well as patience as it may take quite some time to come back to normal.

Physiotherapy for Impingement-

Physiotherapy is usually the first line of treatment for subacromial impingement (tendonitis, bursitis) of the shoulder; along with anti-inflammatories and analgesia. It is very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

  1. Pain Management
  2. Manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly.
  3. You will learn exercises and stretches to help your shoulder and shoulder blade move properly.
  4. Strengthening Exercises
  5. The therapist will teach you the proper posture which is an important part of rehabilitation

In case you have a concern or query you can always consult an expert & get answers to your questions!

3504 people found this helpful
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