STONEGALLOWS

  PHYSIOTHERAPY


What is Physiotherapy?

"Physiotherapy is a science based health care profession concerned with human function and movement and maximising potential. It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in personal health needs."

Generally most injuries get better on their own, within two weeks, with pain decreasing and full function returning. If however the pain persists for longer, then it is likely that some form of intervention is needed. This intervention can take many forms and may be as simple as being given the appropriate exercises or a longer-term treatment plan. In most cases the longer you wait for treatment the more difficult the solution.

Physiotherapists are trained to diagnose problems in the joints and soft tissues of the body, and will carry out a comprehensive assessment and treatment plan for your particular problem. It is difficult to give appropriate advice without properly assessing the problem. Information on this website is intended as a guide only.

We are committed to continually updating our professional skills through ongoing training and attendance at conferences both as delegates and as lecturers. The clinic complies with all the requirements from various regulatory bodies both professionally and with regard to health and safety.

All physiotherapists working at the clinic will be registered with the regulatory body for physiotherapists: the Health and Care Professions Council (or HCPC). The HCPC is an independent, UK-wide health regulator. Wherever you decide to be treated, make sure you see a chartered and registered Physiotherapist. This guarantees that their qualification is properly recognised, they are governed by a professional code of conduct and they are covered by professional liability insurance.

So WHAT DO WE DO at Stonegallows Physiotherapy and HOW CAN WE HELP YOU?

In the section below you will find some of the common terms and conditions explained.
Click on the body diagrams below or use the contents table to find out more about some of the most common conditions where physiotherapy can help. The body diagrams are split into 3 different categories:

Sports and Soft Tissue Injuries
Common Joint Problems
Common Conditions
Everything on the body diagrams is also listed in the contents table
go to sports and soft tissue injuries go to Dislocations go to Neck and Back Pain go to Shoulder go to Elbow go to Wrist go to Hips go to Knee go to Ankle and Foot go to Muscle Strain go to Fractures Stonegallows Physio, Taunton,sports injuries

 all links on this map are available elswhere
go to vertigo and BPPV go to Headaches go to Osteoarthritis go to Osteoporosis go to Rheumatoid Arthritis go to Post Op go to Walking and Posture Stonegallows Physio, Somerset, common conditions
go to Joint Conditions go to Neck Pain and Cervical Spondylosis go to Back Pain and Sciatica go to Whiplash go to RSI go to Posture and Gait go to Gait and Biomechanics go to Dislocations Stonegallows Physio, Taunton, sports injuries

SPORTS AND EXERCISE INJURIES

This term covers a wide variety of conditions. Sport or exercise can be as gentle as a daily walk to work or as rigorous as a weekly rugby match. Sports injuries are as likely to affect an occasional gym goer as the professional athlete. All of us are likely to get injured at sometime or other if we partake in exercise. For most the injury gets better on its own within a couple of weeks, following simple guidelines:-
  • RICE regime (i.e. Rest, Ice, Compression, Elevation.) Your Physiotherapist can further explain this.
  • Relative rest (from sport)
  • Listen to the pain and don't push it too soon
  • Return to normal as soon as possible.
For some the injury is too severe or recurrent and therefore intervention is needed. Physiotherapy aims to promote healing and restore movement, strength and proprioception (balance and joint position awareness) as soon as is possible. A graduated return to sport is essential to decrease the risk of re-injury and an objective realistic view on this is often helpful to an eager athlete!

ELBOW

This joint is commonly affected by tendonopathy (tendonitis), known as Golfers or Tennis Elbow. Tendonopathy is the term used to describe inflammation around a tendon. Treatment is aimed at relieving the symptoms and an ergonomic assessment in the work place or sporting action can help to identify contributing factors, thus allowing adjustments to be made and re-injury less likely.

Classic Signs and Symptoms: -
  • Pain over inside (Golfers Elbow) or outside (Tennis Elbow) of the elbow joint
  • Tender to touch this area i.e. "bruised"
  • Weakness and pain on lifting or using hand
Treatment: -
  • May require a clasp (or brace) to be fitted.
  • Electrotherapy
  • Deep massage
  • Stretching exercises.

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Wrist treatment at Stonegallows Physio, Taunton

WRIST

Tendonopathy (inflammation around a tendon) is a common problem in this area. Treatment is aimed at relieving the symptoms and an ergonomic (functional) assessment in the work place or sporting action can help to identify contributing factors, thus allowing adjustments to be made and re-injury less likely.

Signs and Symptoms:-
  • Pain on movement of the wrist joint (particularly repetitive activities)
  • Tender to touch in a specific area around the wrist
  • Possilbe restricted movement of the wrist
  • Difficulty lifting or gripping, this may affect all activities of daily life
- see also RSI (repetitive strain injury)

Treatment:-
  • May require a splint ( to reduce strain on the joint)
  • Electrotherapy,
  • Deep massage,
  • Stretching and exercises.
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SHOULDER

The shoulder is a complicated joint. It has a vast range of movement controlled by an array of muscles. Its large range of movement predisposes it to injury. Common problems are dislocation of the joint and tendonopathy of the surrounding muscles.
Due to the complexity of the joint, problems do not usually settle easily or quickly. if symptoms persist then it is advisable to seek help.

Classic Signs and Symptoms for tendonopathy: -
  • Pain around the shoulder region
  • Decreased range of movement
  • Difficulty sleeping especially lying on the affected side
  • Pain radiating down the arm

Treatment: -
  • Deep massage and electrotherapy
  • Exercises for range of movement and strength
  • Shoulder mobilisations
  • Muscle strengthening and balancing exercises
  • Spinal mobilisations
  • Posture advice
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HIP

The hip is not a commonly injured joint, due to its anatomical structure. However it is the soft tissue around the joint that tends to breakdown. Strong muscles, which act on and around the joint, are prone to injury under stress, as are the joint ligaments. Physiotherapy promotes healing and also improves flexibility, preventing re-injury.

Classic Signs and Symptoms: -
  • Sudden pain on activity.
  • Limping, focal pain and tenderness.

Treatment: -

  • Soft tissue massage
  • Electrotherapy
  • Stretching and strength exercises
  • Graduated return to exercise
  • Gait re-education

See also Osteoarthritis
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KNEE

This is a common joint injured in sport. The mechanical forces acting over this joint are large. The surrounding muscles must be strong to take the load off the other soft tissue structures, such as ligaments. Following an injury there is disruption of this mechanism. Intervention is needed to help resolve this.

Growing, sporty adolescents commonly acquire a soft tissue problem called "Osgood Schlatters". This is pain and swelling at the attachment of the Patella Tendon onto the tibia. The adult often experiences problems with their patellofemoral joint (anterior knee pain) following periods of over or under activity. Pain from ligamentus structures (e.g. anterior cruciate ligament - ACL) and cartilage (meniscus) usually follow specific injuries.

Common Signs and Symptoms: -
  • Sudden onset of pain at time of injury.
  • Focal pain accompanied by limping or inability to weight bear, lack of movement and weakness (or giving way).
Treatment:-
  • Soft tissue massage
  • Electrotherapy
  • Stretching and strength exercises
  • Graduated return to exercise
  • Gait re-education
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Joint treatment at Stonegallows Physio, Taunton

ANKLE AND FOOT

A twisted ankle is a common injury. It usually involves a sprained ligament resulting in swelling, pain and sometimes bruising. Many injuries in this area lead to difficulty walking.
Most minor problems settle within a couple of weeks. However the foot and ankle are very important in balance and this is affected when you injure this area. balance (proprioception) can be helped with exercise, without it the injury is likely to recur. The make up of the foot and how we use it are often described as the "biomechanics" of the foot. This can be assessed and simple problems addressed within the physiotherapy assessment. However more complicated problems are best referred onto a podiatrist for an in-depth assessment. Again the adolescents can get their own common problem in the foot called "Severs" disease. Intervention is advisable to try to prevent this becoming chronic.
Other Common ankle and foot problems are Plantar Fasciitis (Pain on the sole of the foot), Achilles Tendonopathy (pain in the tendon at the bottom of the calf) and Metatarsalgia (pain at the bases of the toes).

Common Signs and Symptoms:-

  • Sudden pain on activity
  • Limping, focal pain and tenderness,
  • Swelling, bruising

Treatment:-
  • Soft tissue massage
  • Electrotherapy
  • Stretching and strengthening exercises
  • Proprioception (balance) exercises
  • Graduated return to exercise
  • Gait re-education

(see also Gait and Biomechanics)
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ACUTE NECK AND BACK PAIN

Acute pain in these areas can arise from taking part in many forms of exercise. Particularly in some team sports e.g. rugby, or the incorrect lifting of weights. The pain can arise from the small joints in the spine, surrounding muscles, spinal discs or the nerves, which exit the spinal cord through the bones in the spine. As with any acute injury it is important to take rest while continuing with minimal activity on a day to day basis. If the pain does not settle within a couple of weeks then it would be advisable to seek help.

Common Signs and Symptoms: -
  • Acute and sudden onset of pain.
  • Inability to move.
  • Difficulty sleeping.
  • Pain in limbs
  • Areas of numbness and/or pins and needles.
Treatment: -
  • Mobilisations to the affected area.
  • Hot/cold therapy
  • Electrotherapy
  • Home exercises
  • Muscle strengthening and recruitment exercises.
  • Lifting advice
  • Gait re-education
  • Acupuncture

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MUSCLE STRAINS

In sport the leg muscles can be placed under a lot of strain. The two most commonly injured muscles in the leg are the Hamstrings (at the back of the thigh) and the Gastrocnemius (in the calf). These are used explosively when you sprint from a standing position. Strength and flexibility are very important in these muscles and correct rehabilitation is vital.

Common Signs and Symptoms:-
  • Sudden pain on activity
  • Limping
  • Focal pain and tenderness
  • Swelling bruising
Treatment:-
  • Soft tissue massage
  • Electrotherapy
  • Stretching and strength exercises
  • Graduated return to exercise
  • Gait re-education
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FRACTURES / BROKEN BONES

In most cases you are put in a plaster, or cast, following a fracture. This allows the bone to heal in a good alignment. The immobilisation also means that the joints enclosed in the cast are restricted and become stiff. When the plaster comes off, the joints are uncomfortable to move. The soft tissues (muscle, ligaments or tendons) are unused to being stretched and it will feel strange for a time. It is important to remember that if you have sustained a fracture that the surrounding soft tissue will also have been damaged. Once the bone has healed the soft tissue may need treatment to get back to normal. Physiotherapy can offer local treatment to the stiff joint or soft tissue and advice on a graduated exercise programme to regain full use.

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DISLOCATIONS

Any joint can be dislocated if you sustain the "correct" injury. However the most common one is the shoulder. If your joint is dislocated it invariably feels like it has "popped out" and may go back in straight away, or need a trip to A&E to relocate it. The severity of the dislocation will dictate the rehabilitation regime. Usually there is a period of healing, followed by rehabilitation where you regain joint movement and strength. Recurrent dislocations are usually referred to Orthopaedic surgeons and seen by physiotherapists to try to strengthen and prevent further problems.


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POST-OPERATIVE TREATMENT

After any orthopaedic operation, physiotherapy is essential for getting the best result. In the initial stages, the rehabilitation protocol is set in discussion with the Consultant. Basically, Physiotherapy will help you to regain muscle strength and movement using a range of exercises. For lower limb surgery, gait re-education is also vitally important to prevent a persistent limp. Treatment for pain relief may also be required along with reduction of swelling and bruising and assistance with soft tissue healing. After discharge from hospital, you may need to continue to see the physiotherapist until you have achieved your maximum function.

Examples of some common operations requiring Physiotherapy Rehabilitation:-

JOINT REPLACEMENT
    Total Knee Replacement (TKR)
    Total Hip Replacement (THR)

SPINAL SURGERY
    Decompression / Discectomy
    Fusion

SHOULDER SURGERY
     Sub-acromial Decompression (SAD)
    Rotator Cuff Repair

KNEE SURGERY
    Arthroscopy / Menisectomy
    Cruciate Ligament Reconstruction (ACL)

Physiotherapy may also help you to regain muscle strength and movement after a long illness.

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There is no one single cause of headaches. There are many different types of headache patterns and a number of causes have been identified which tend to fall into two general categories, tension headaches or migraine. Headaches can also be caused by problems in the neck.

Headaches involve mild to severe pain in one or more parts of the head as well as the back of the neck. Migraines may also be accompanied by an aura which could include visual, hearing and taste disturbance.

Physiotherapy treatment is aimed at headaches which arise from problems in the neck through treatment with mobilisations and active exercises. Acupuncture can also be very effective.


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VERTIGO ⁄ BPPV (Benign Paroxsysmal Positional Vertigo)

Definition: "A false sensation of motion or spinning that leads to dizziness and discomfort."

Symptoms: Short lasting but severe sensation of the room-spinning. Often accompanied by nausea or vomiting. Feelings of unsteadiness and queasiness which can last from a few minutes to several hours but then resolve completely. Vertigo is often first noticed when turning over in bed.

Physiotherapy Treatment: Vertigo can be very frightening so treatment will require a lot of sympathy and reassurance. Special manoeuvres can be performed to help rebalance the balance (vestibular) system and this is often combined with very specific vestibular rehabilitation exercises.


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RHEUMATOID ARTHRITIS (RA)

Rheumatoid Arthritis is a chronic, progressive and disabling auto-immune disease affecting a small percentage of the population. It is an incredibly painful condition, which can cause severe disability, ultimately affecting a sufferer's ability to carry out everyday tasks.

Symptoms: Inflamed joints, which are swollen, red and hot. Over time, damage occurs to the cartilage and bone around the joints. Any joint may be affected but it is commonly the hands, feet and wrists. Physiotherapy will help with pain relief and joint mobility exercises as well as providing advice on day-to-day self-help.


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OSTEOARTHRITIS (OA)

Osteoarthritis is the most common form of arthritis. It occurs when the cartilage covering the end of bones becomes thin and worn. Osteoarthritis usually develops gradually over years, it most often affects the knees, hips, feet, hands, and sometimes the neck and lower back.

Common symptoms: painful, stiff joints, swelling, muscle weakness and loss of function.

Physiotherapy can play an important role in treating this painful condition. A range of techniques are used to relieve pain and stiffness, and to improve mobility, co-ordination and posture. Manipulation and specific exercises help to ease pain, build stamina and mobilise joints. Other pain relieving treatments include hot and cold treatments, TENS and acupuncture.


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Posture treatment at Stonegallows Physio, Taunton

POSTURE

Posture is simply the alignment between various parts of the body. It is the foundation for all movement and affects the whole of the body. Good posture encourages good movement patterns and involves finding a way of moving and keeping upright as effortlessly as possible. If you are in the right posture the right muscles are working and the joints will be able to move properly. This helps to keep the joints healthy and reduce wear and tear.

Our posture and way of moving is very much a habit, and like everything else we do it is easy to develop bad habits. Luckily we have the ability to change our posture and movement habits if we put our minds to it. Good posture helps to get the right balance between strong muscles and lazy muscles resulting in less aches and pains.

Physiotherapy treatment will assess posture and teach specific exercises, combined with appropriate advice, so that the spine can stretch out and move better so reducing pain.

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GAIT / BIOMECHANICS

Gait, or walking pattern, is a complex activity involving most parts of the body. Our gait varies according to our individual anatomy, our age and the speed we are travelling. Pain, muscle weakness, joint stiffness and altered biomechanics can result in abnormal gait patterns.
Biomechanics is the study of the body's movements during walking, running and sports, and the effect of these movements on other parts of our bodies. Excess 'pronation' (rolling over of the foot to maintain contact with the ground) often leads to common foot problems such as: fallen arches / flat feet, pain in the ball of the foot, heel pain (plantar fasciitis) and Achilles tendonopathy (pain in the tendon at the bottom of the calf). Altered foot biomechanics can also contribute to knee, hip and lower back pain.

Physiotherapy is used after gait assessment to plan an individually tailored rehabilitation programme, including strengthening and stretching exercises for both muscles and joints to increase range of movement and relieve pain as well as providing movement re-education. The clinic works closely with a Podiatrist to help with comprehensive rehabilitation.


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OSTEOPOROSIS

Osteoporosis literally means 'porous bones'. Our bones are made up of a thick outer shell and a strong inner honeycomb mesh of tiny struts of bone. Osteoporosis means some of these struts become thin or break. This makes the bone more fragile and prone to break. As we age, our bones lose mass as part of the natural ageing process - so we are all at risk of osteoporosis. It is estimated 3 million people in the UK have osteoporosis - 1 in 3 women and 1 in 12 men will suffer from the condition over the age of 50.

The consequences of osteoporosis can be devastating. Problems range from multiple fractures, specifically in the spine, hip and wrist, changes in posture, deformity such as a dowagers hump (collapse of the spine), height loss and pain.

Physiotherapy Treatment will provide a specific exercise programme to both help to maintain bone strength and good posture. Pain relief may also be required along with dietary and life style advice.


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BACK PAIN ⁄ SCIATICA

Sixty percent of adults suffer from back pain every year, and half of these go on to become chronic sufferers. Back pain is commonly the result of poor posture, an injury or overuse, affecting the muscles, ligaments, joints or discs, causing pain anywhere in the back, muscle spasm and soft tissue soreness, loss of movement and restriction of function.

Sciatica is pain arising in the sciatic nerve. The sciatic nerve is the largest nerve in the body, running from the spinal cord down through the buttock and the back of each leg to the foot. Sciatic pain is most often caused by abnormal pressure on the nerve roots in the spinal cord.

Physiotherapy treatment for back pain will consist of a thorough assessment, followed by selection of appropriate treatment modalities which may include manual therapy, active exercise, postural correction and advice to reduce the risk of recurrence.

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REPETITIVE STRAIN INJURY (RSI)

RSI is caused by any repetitive movement that leads to muscular pains or problems with nerves, ligaments and joints, mainly in the upper limbs. RSI is usually work related and the incidence has risen dramatically with the use of word processors and other automated equipment, which need only a limited range of movement.

Many people can be affected, including computer operators, typists, musicians, shop staff and factory workers.

Physiotherapy treatment includes assessing the affected person's posture, workplace, lifestyle and work patterns. A treatment programme will include stretching exercises, mobilisation and electrotherapy, such as ultrasound, to speed up the healing process and preventative advice. If treatment is delayed, RSI can take longer to clear up.


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PAIN RELIEF

Pain has a significant impact on our mental as well as physical well-being. Pain relief is a major factor in the treatment of a wide range of conditions from fractures and back pain to arthritis and osteoporosis.

Physiotherapy Treatment: Mobilisation of joints can help to reduce pain and stiffness and heat or ice can help to reduce inflammation as well as offering pain relief. Electrotherapy, such as TENS, Ultrasound and Interferential can assist with healing and also relieve pain. Other types of treatment include acupuncture and specific exercises to increase energy and increase the feeling of well-being.


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WHIPLASH

Whiplash occurs when a sudden movement or forceful jolt to the body or head causes damage to the soft tissues in the spine. It is most commonly associated with car crashes, however, the condition can also result from a blow to the head or through long-term repetitive damage to the neck. The ligaments, tendons, muscles and joints in the neck are stretched and strained. Symptoms of whiplash often do not appear when the injury is caused. It may take 6-12 hours for symptoms to show and they may continue to get worse in the days after the injury. Sometimes, it may even take a few days for any symptoms to show.

Common symptoms of whiplash are:

Pain, stiffness and loss of movement in the neck. Other symptoms can include, headaches, muscle spasms, pain in the shoulders or arms, tenderness along the back of the neck, pain in the lower back, pain or numbness / pins and needles in the arms or hands, dizziness, tiredness, sometimes whiplash can even lead to loss of memory, poor concentration and irritability.

Physiotherapy Treatment

Usually, symptoms begin to improve after a few days and in around 60% of cases, symptoms completely disappear after four weeks. Pain relief is very important in the early stages to assist healing of the damaged tissue. Rest may be required in the first few days but then normal movement, through active exercises is encouraged as much as possible. Good posture is very important.

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NECK PAIN ⁄ CERVICAL SPONDYLOSIS

Cervical spondylosis (degenerative osteoarthritis) is usually a natural consequence of ageing, although it is also possible for it to develop at a young age. About half the population develop cervical spondylosis by the age of 50, with this figure rising to 70% by the age of 60. Cervical spondylosis affects both sexes, but men usually develop it at an earlier age than women. Over the years, the vertebrae (bones in the neck) undergo wear and tear, which can lead to cervical spondylosis. However, neck injury may trigger the degeneration, especially when it occurs in younger men.

Symptoms: pain and stiffness in the neck which may spread to the shoulders and occasionally radiate down the arm or cause pins and needles.

Physiotherapy is aimed at pain relief and may involve joint mobilisation techniques and active exercises to increase range of movement and improve posture.

See also:
Whiplash
Acute neck and back pain

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ACUPUNCTURE

Acupuncture at Stonegallows Physio, Taunton

Acupuncture is one of the oldest recorded forms of medicine, having been used for many centuries by the Chinese. It is a system for treating disease using fine needles inserted into specific points of the body. These points are thought to have an effect on balancing particular organs or organ systems.

Research has shown that 70% of people gain relief from pain with acupuncture. It does not work for everybody and every condition, but frequently good results are achieved when more conventional medicine has failed. The effects of acupuncture are cumulative and pain relief builds up as treatment progresses. Some people are very good responders, whereas others may see little benefit until they've had a few treatments (which is more likely with chronic conditions). Symptoms may become slightly worse at first, but this is nothing to worry about as it usually means the condition will respond well to treatment. One of the exceptional features of acupuncture is that there are virtually no side effects. However, patients who are pregnant or epileptic are advised against receiving this type of treatment.

Acupuncture is perfectly safe when carried out by members of the Acupuncture Association of Chartered Physiotherapists (AACP). Ros is a member of the AACP, she is trained to use the strictest hygiene and the needles used are disposable and pre-sterilised. AACP members are in a unique position of having the ability to combine acupuncture with other natural treatment methods, such as exercise, manipulation and relaxation techniques.

 

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CHILDREN ⁄ YOUNG ADULTS

Ros and Claire have a special interest and experience in working with children and young people with musculo-skeletal and soft tissue injuries. Children and teenagers present with a wide range of conditions some of which are specific to them.

We are DBS checked and appropriate child protection and safe guarding trainings are regularly updated.


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Stonegallows Physiotherapy

6 Stonegallows, Taunton, TA1 5JN    T: 01823 330689    E-mail: roswills@sgphysio.co.uk


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