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I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know. He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication. Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain. He said yes. But the adjustments hurt his hip so bad that he could not continiue. So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia). MDs and Chiropractors see pain as neuropathic pain( nerve pain). With that asumption they give the wrong treatments and therapies. Now there is no denying that at times injections and surgery is needed. Not denying that. But most of the time - NOT. 70% to 85% of all pain comes directly from trigger points. Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery. I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors. Another very painful spot on his right greater trochantor. A painful spot in the middle part of his lower right hamstrings. And also a tender spot on the right spinous of L3. I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem. Because a healthy body had no painful spots even with deep massage. Ive been hunting and eliminateing trigger points for thirty years now. He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain. I assume the other way around. I'm a Massage Therapist.
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There is not one day that goes bye, that does not involve trigger point activity. Not one. The other day was no exception. One of my regulars came in. Well she was a regular. But I had not seen her in over a year. She was seven months pregnant though. . I asked her if she had any aches or pains. She indicated her low back and lateral thighs. While she was discribing her pain I noticed that she used her left hand and only touched the left side of her body. I told her that before i start her massage( an 80 minute session), that I would palpate her body from both her lateral thighs up to her mid back level. And that if I touched any tender sposts for her to tell me.. Then we would deactivate each spot.. Then go on with her massage. And before she gets off the table, we would re check those tender areas to make sure they were all gone.. She said ok. To my suprise I found only three sore spots.. They were very tender though.. Very sore. On her right side I only found one trigger point or tender spot. It was on her left Trochanter of the femur. And on the right side I found only two spots.. They were very tender though. Same as the other side, the Trochanter and a very tender left lateral spinous at L2. I was able to deactivate those three trigger points rather quickly. Then carried on with the massage. But I could not help thinking , while I was massaging her, thaat there had to be more trigger points on the left side of her body just judging by her body language as she was telling me about her pain and discomfort.. She also told me that she sleeps mostly on her left side, and that it gets numb at night and she has to shift positions because of it. So anyway, near the end of the massage I re checked those three tender spots, and none of them were there. I told her I wanted to recheck her lateral thighs just to make sure we did not miss anything.. and sure enough I found a very tender vastus lateralis trigger point on the left lateral leg. I had somehow missed it during my preliminary check. Any way I was able toI down graded that quickly. After the massage she said she felt great; And that her low back and thighs were no longer hurting. I told her that being pregnant and sleeping as she had too probubly were the perpetuating factors of the pain in those areas. And that after she has her baby those perpetuating factors will no longer be present.. And that she should come in and let me deactivate those tender areas once and for all. She said, yea it makes sense.
Gosh you guys.. sorry. I re read my post.. I make a lot of typo errors. I found only one trigger point on the right side of her body... and three on her left. Trochanter on the right. On the left... lateral spinous at L2, trochanter and vastus lateralis. sorry I cant spell or type. If you are confused by anyting I say.. just ask. Also Im not telling anyone what to do or how to do things. Im just telling what I think and do. Thats all.
Gordon J. Wallis said:
There is not one day that goes bye, that does not involve trigger point activity. Not one. The other day was no exception. One of my regulars came in. Well she was a regular. But I had not seen her in over a year. She was seven months pregnant though. . I asked her if she had any aches or pains. She indicated her low back and lateral thighs. While she was discribing her pain I noticed that she used her left hand and only touched the left side of her body. I told her that before i start her massage( an 80 minute session), that I would palpate her body from both her lateral thighs up to her mid back level. And that if I touched any tender sposts for her to tell me.. Then we would deactivate each spot.. Then go on with her massage. And before she gets off the table, we would re check those tender areas to make sure they were all gone.. She said ok. To my suprise I found only three sore spots.. They were very tender though.. Very sore. On her right side I only found one trigger point or tender spot. It was on her left Trochanter of the femur. And on the right side I found only two spots.. They were very tender though. Same as the other side, the Trochanter and a very tender left lateral spinous at L2. I was able to deactivate those three trigger points rather quickly. Then carried on with the massage. But I could not help thinking , while I was massaging her, thaat there had to be more trigger points on the left side of her body just judging by her body language as she was telling me about her pain and discomfort.. She also told me that she sleeps mostly on her left side, and that it gets numb at night and she has to shift positions because of it. So anyway, near the end of the massage I re checked those three tender spots, and none of them were there. I told her I wanted to recheck her lateral thighs just to make sure we did not miss anything.. and sure enough I found a very tender vastus lateralis trigger point on the left lateral leg. I had somehow missed it during my preliminary check. Any way I was able toI down graded that quickly. After the massage she said she felt great; And that her low back and thighs were no longer hurting. I told her that being pregnant and sleeping as she had too probubly were the perpetuating factors of the pain in those areas. And that after she has her baby those perpetuating factors will no longer be present.. And that she should come in and let me deactivate those tender areas once and for all. She said, yea it makes sense.
Thanks Gordon. That's what I had thought since some of those muscle are so deep, they can't be palpated or hard to palpate per se.
Gordon J. Wallis said:
I'm only describing location. When I say paraspinals I'm talking any where lateral of the spinous process from maybe a half inch to three inches. If I say lateral spinous , I mean right up on the spinous left or right side. Bucket loads of muscles attach to the spinous. If I say upper trap, I mean top of the shoulder. If I say rhomboids it could be the paraspinals, mid trap or whatever. For me, I dont really need to know exactly what muscle.
Maryshka said:Hi Gordon,
When you mention paraspinal locations, are you referring to specific deeper muscle groups (multifidus, longissmus, rotatores, etc.) or more superficial muscles that could harbor TrPs (lower Traps, medial area of Lats, serratus posterior obliques for example)? Trying to get a visual on what you're describing.
Thanks!
Gordon J. Wallis said:Not everybody I work on thinks they are on the edge of surgery or has fibromyalgia. Most people have just a few aches and pains. Not enough to make them run to a doctor or even get a massage for. But its always trigger points. The other day a lady came in for a massage. Id never seen her before. I asked her what she needed from the massage, and I got the usual answer. Just to relax. Then I showed her a testimonial like the ones I posted on this thread. Then she said. Well I do have a back problem. I asked her if she saw anyone for her back problem. She said oh no, its not that serious. Every once in a while I might have to take an Alieve or something, and that takes care of it. My back did hurt this morning, but it feels fine now. I told her I would take two or three minutes before the massage to examin her back for any tender areas. She said ok. I found two tender spots on the para spinals on each side of L5. And a tender spot on the paraspinals at T10 left side, and another at T9 right side para spinals. She had four latent trigger points. They were un noticed until palpation and had no radiation patterns. I took a few moments to eliminate those sore spots, then carried on with the massage. Before the end of the massage I re palpated to see if those trigger points were still there. They were not. Of course everyone feels good after a massage. But I have a real observable way to gage the success of my massage work. And the client notices too. I dont think I helped her. I know I helped her. And the client knows too.
Sometimes it's better to keep it simple {:o}
Gordon J. Wallis said:
Some where in this thread I already answered your question. But the big word is stress. Emotional stress or physical stress. Excessive worry, like grinding your teeth at night when you sleep. Or repetitive movements over and over again. One position too long. A fall or a blow from an accident. The muscle cell is a structure, and it can be broken or damaged like any structure.
Maryshka said:What are some examples of what can damage sarcoplasmic recticulum?
Gordon J. Wallis said:Another follow up. I saw her again today. It was her fourth visit. When she came in she told me she has been pain free sense her last session. And when I palpated her. There were no more tender spots. The last session only the sacrum trigger point was left. Now its gone along with her low back pain. This big medical clinic she went to told her she needed surgery. Give me a break! I wonder how many people they have told that too? She is going to write a testimonial about her experience with her back pain. And I will be able to show that to other clients. But Truth Remains Hidden. And I think it always will. In the attachment below is a diagram of a muscle cell. It shows the sarcoplasmic recticulum that controles calcium flow within the muscle cell. When the sarcoplasmic recticulum is damaged, a trigger point forms.
Gordon J. Wallis said:Just as a follow up. I saw this client the other day for the 3rd time. Three of the trigger points are now gone. The two L5 TPs, and the QL TP. Only the upper sacrum one remained. And I was able to greatly down grade that TP this last session. They are short 15 minute sessions. Usually if I'm able to eliminate all the TPs, the clients symptomatic complaint goes away too. In her case, low back pain. And I have a real good way to gauge the success or lack of success by the number of TPs each session. She started with four, now she has only one, after three sessions. After this last sessin she says she can feel the difference and it feels good. If I can't eliminate the TPs and or symptoms after a few sessions I tell them I can always massage them but I won't be able to help them with their pain problem.. Im not going to rip anyone off with endless sessions with no improvement. There should be noticeable improvement after four to six sessions in order to justify additional appointments in my opinion.
Gordon J. Wallis said:Here is another experience that fits into this thread. A new client. Initially she told me she just needed to relax.. After I showed her a testimonial from a client that I was able to help out of pain, she told me that she does have chronic lower back and hip pain. I asked her how long she has had this pain she said, three years. Ever sense the birth of her last child. She said the pain is constant. But she can live with it. Her doctor told her that it might be from a uterus problem.. She went to an orthopedic clinic and they told her she needed surgery.. But she refused to sign all the paper work because nothing was guaranteed. After she told me that.. I palpated her entire hip area( both hips) and back, all the way up to her neck. What I found was a mild trigger point on her QL at the illiac crest border.. and a very painful trigger point on her upper sacrum just to the right of the sacral ridge. And in addition two very painful trigger points on her spinal erector group on each side of her L4 L5 areas. By the end of the session I had eliminated those trigger points as well as her chronic low back pain. Most medical doctors do not understand muscle pain. Its more then obvious to me now. Three years she sufferd, with the option of surgery? Uhm. She was pain free when she left.. She told me.. Now she will need a couple of follow ups to make sure those TPs do not come back.. But her problem is over. If you have followed this thread. You know that 80% of all pain comes from trigger points.. Anyway I will post a couple of attachments.. One is not very clear and does not show any pain pattern, but the QL one does. Truth remains hidden. So many are being ripped off and misdiagnosed.
I find I'm gravitating toward MFR/CST/TrP release/acupressure in an integrated Swedish. I found that people SAY they want a relaxation massage but during intake, they point out all the areas that they want treated -- and that isn't necessarily going to be 'relaxing' when there is serious work to do.
Therese Schwartz said:
Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
From that attachment info, you'd think that reputable therapeutic (TrP release) MTs would be more highly regarded/respected and command a doctor's salary for getting to the origin of the problem, esp. with pts/clients experiencing FBS (Failed Back Surgery) cuz no one talks and works on soft tissue damage (atraumatic or traumatic) properly. How many post-surgical patients end up on drugs for chronic pain? That is not a successful outcome and doctors should not get paid until they 'fix' the problem -- kind of like your mechanic. Ugh.
Gordon J. Wallis said:
Think about it Therese. You helped her when highly educated medical doctors could not. Check the attachment.
Gordon J. Wallis said:Way to go Therese !!!!
Therese Schwartz said:Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
I think most people just plain want to feel better, and most of them have given up hope that it's possible to feel better.
As I get more skilled and experienced, I'm finding that even "deep" work can be relaxing for people, if it's implemented by listening to and following the tissues for timing and pressure. The skills necessary for following the tissues that carefully take time to develop! And I'm not very patient. ;-)
Maryshka said:
I find I'm gravitating toward MFR/CST/TrP release/acupressure in an integrated Swedish. I found that people SAY they want a relaxation massage but during intake, they point out all the areas that they want treated -- and that isn't necessarily going to be 'relaxing' when there is serious work to do.
Therese Schwartz said:Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
If or when you know what you are doing. You never hurt the person. They never have to take the pain in order to heal.
Maryshka said:
I find I'm gravitating toward MFR/CST/TrP release/acupressure in an integrated Swedish. I found that people SAY they want a relaxation massage but during intake, they point out all the areas that they want treated -- and that isn't necessarily going to be 'relaxing' when there is serious work to do.
Therese Schwartz said:Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
Remember we are just typing on line. Lots of muscles can be palpated. And sometimes I do need to know what muscle is sore. But often times a tender spot in a certain area indicates a certain muscle. And sometimes you have to palpate deeper to find the sore spot. But someone that has been hurting for a while or years. Its usually not to difficult to touch the spot thats most tender. Its hard to explain by typing exactly what I do when I work on a client. But one thing that has helped me is that I have a system and a way to measure my progress. First vist 20 trigger points. Second visit. 20 trigger points. Third visit 11 trigger points. Fourth visit 1 trigger point. Fifth visit no trigger points, and the clients incoming complaint is no longer there. A good book you might be interested in is. The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching by Joseph E. Muscolino.
Maryshka said:
Thanks Gordon. That's what I had thought since some of those muscle are so deep, they can't be palpated or hard to palpate per se.
Gordon J. Wallis said:I'm only describing location. When I say paraspinals I'm talking any where lateral of the spinous process from maybe a half inch to three inches. If I say lateral spinous , I mean right up on the spinous left or right side. Bucket loads of muscles attach to the spinous. If I say upper trap, I mean top of the shoulder. If I say rhomboids it could be the paraspinals, mid trap or whatever. For me, I dont really need to know exactly what muscle.
Maryshka said:Hi Gordon,
When you mention paraspinal locations, are you referring to specific deeper muscle groups (multifidus, longissmus, rotatores, etc.) or more superficial muscles that could harbor TrPs (lower Traps, medial area of Lats, serratus posterior obliques for example)? Trying to get a visual on what you're describing.
Thanks!
Gordon J. Wallis said:Not everybody I work on thinks they are on the edge of surgery or has fibromyalgia. Most people have just a few aches and pains. Not enough to make them run to a doctor or even get a massage for. But its always trigger points. The other day a lady came in for a massage. Id never seen her before. I asked her what she needed from the massage, and I got the usual answer. Just to relax. Then I showed her a testimonial like the ones I posted on this thread. Then she said. Well I do have a back problem. I asked her if she saw anyone for her back problem. She said oh no, its not that serious. Every once in a while I might have to take an Alieve or something, and that takes care of it. My back did hurt this morning, but it feels fine now. I told her I would take two or three minutes before the massage to examin her back for any tender areas. She said ok. I found two tender spots on the para spinals on each side of L5. And a tender spot on the paraspinals at T10 left side, and another at T9 right side para spinals. She had four latent trigger points. They were un noticed until palpation and had no radiation patterns. I took a few moments to eliminate those sore spots, then carried on with the massage. Before the end of the massage I re palpated to see if those trigger points were still there. They were not. Of course everyone feels good after a massage. But I have a real observable way to gage the success of my massage work. And the client notices too. I dont think I helped her. I know I helped her. And the client knows too.
Good reminder Gordon.
Gordon J. Wallis said:
If or when you know what you are doing. You never hurt the person. They never have to take the pain in order to heal.
Maryshka said:I find I'm gravitating toward MFR/CST/TrP release/acupressure in an integrated Swedish. I found that people SAY they want a relaxation massage but during intake, they point out all the areas that they want treated -- and that isn't necessarily going to be 'relaxing' when there is serious work to do.
Therese Schwartz said:Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
Gosh there was a time 20 to 30 years ago I use to go intensly deep on people. I prided myself on being able to work so deeply. And surprisingly I had clients that wanted it. They could take the pain in order to get well. I somehow was able to help some.. But gosh I look back now. That was not the right way to do it. Lucky I didnt hurt anybody.
Maryshka said:
Good reminder Gordon.
Gordon J. Wallis said:If or when you know what you are doing. You never hurt the person. They never have to take the pain in order to heal.
Maryshka said:I find I'm gravitating toward MFR/CST/TrP release/acupressure in an integrated Swedish. I found that people SAY they want a relaxation massage but during intake, they point out all the areas that they want treated -- and that isn't necessarily going to be 'relaxing' when there is serious work to do.
Therese Schwartz said:Glad to! I'm glad it's helpful! As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo. I used a combo of mostly CST and a little MFR.
Maryshka said:Thanks for this post. Helpful!
Therese Schwartz said:I had a new client Monday; 66 years old, just started having bad headaches earlier this year. They start in her neck and end in her left eye. She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her. What?!? She didn't take it for very long - it made her feel terrible). So as much as possible, any underlying pathology has been ruled out. I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.
I started working on her neck and she could feel the tension in her eye (which I expected). By the time I was done, I could work on her neck with no tension/pain in her eye. She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).
I love my job! :)
Thanks for the continued posts and education. My clients and I are most definitely benefiting from what you have to say.
I had a new client the other day. She was scheduled for an 80 minute massage. I asked her if she had any aches and pain., She told me her right shoulder was killing her. I asked her if she was seeing anyone for her shoulder pain. She said she sees an Osteopath. I showed her one of my testimonials and asked her if she wanted me to see if I could help her with her shoulder pain. She said yes. I told her I would palpate from her hips to the base of her skull, and that she would have to tell me if I come to or touch a sore spot. Her symptomatic complaint was her painful right shoulder. So I wanted to check as much of her body as possible. Im not a structural guy.. But I do know that if one hip is higher for example, that something else compensates in order to make sure the eyes are parrallel to the ground. So any way.. I found four trigger points. I found a trigger point on her left Gluteus medius. A very sore trigger point on the border of her right scapula about the T7 level, and a tender T3 and T12 latearal spinous trigger points on the right side. I deactivated those areas quickly and carried on with her massage. Near the end of the massage I re checked those same areas.. All were gone except the left gluteus medius. I again eliminated it. When she came out of the massage room. She said her shoulder was pain free. I suggested to her that she reschedual for a brief follow up session to make sure all those tender areas were gone. I don't know if she did or if she will.. But I always find trigger points involved in anyones pain problem.. Big or small.
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