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Plantar Fasciitis

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Plantar Fasciitis

Old 04-02-15, 07:07 PM
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Former PF sufferer (2-3 years). For me riding really helped. It was easy to stretch on the bike so I did it often. I wore the boot for several months. I also wore (and still wear) high arched insoles in all of my shoes including cycling. It gradually got better and now I only have some early morning pain when walking barefoot. I just ran my first half marathon about 4 months after the pain finally went away. I can't say how great it feels to be walking and running pain free. Hang in there it does get better.

I had just the opposite results from the above. I wore those Rebok flex shoes for several months before developing PF. I don't know if they caused it but my feet didn't like them after a while. I need support for my arches. Walking barefoot on hard surfaces still is not the most pleasant thing but I can tolerate it for short periods. I couldn't even think about running barefoot except on the beach.
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Old 06-05-15, 08:21 AM
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Its been a few months and sadly, there hasn't been much change. Its better some days than others but at least for now I've hung up the bikes and will probably be out the rest of the season, though I do plan on putting a bike on a trainer to at least try to keep in shape. Even mountain biking is starting to flare up the PF where in the past it hasn't. I've been in physical therapy for a few months. They've been doing astem massage & ultrasound on it. All that's done really is seems to aggravate it for a few days after the session. Still working on getting orthodics. I had an appointment to get custom fitter but had to cancel due to a family emergency. I go back to the doc next week. Really getting pretty discouraged by it.

Last edited by bres dad; 06-05-15 at 08:29 AM.
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Old 06-05-15, 08:27 AM
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Go to a physical therapist. They will help you out big time
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Old 06-05-15, 08:34 AM
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I've been seeing one for 8 weeks (listed as PT in my above post, edited it.) Even they admitted this is a rather pesky case that won't go away easily. I also have collapsing arches in the same foot, so there's two things going on (maybe even a little Tarsal Tunnel Syndrome). I need a new foot... lol (sigh)
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Old 06-05-15, 09:25 AM
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What are you doing beside the therapy since you don't have inserts yet?

An update for me, my PF pain is gone, and I mean gone. I never go barefoot and always wear those ugly Crocs at home, even when I get up to pee at night. I'm a clyde too, so I know there is some weight getting smashed onto my foot when I walk and ride.
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Old 06-05-15, 10:18 AM
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Originally Posted by bres dad
I've been seeing one for 8 weeks (listed as PT in my above post, edited it.) Even they admitted this is a rather pesky case that won't go away easily. I also have collapsing arches in the same foot
Yeah, orthotics mentioned in your prior post should help. Mostly likely you over-pronate (foot rolls to the inside giving appearance of flat feet or fallen arches). You may also have a shorter first toe than the second and maybe a gap between the first and second toe which makes the problem apparent.
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Old 06-05-15, 10:27 AM
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Originally Posted by bres dad
I've been seeing one for 8 weeks (listed as PT in my above post, edited it.) Even they admitted this is a rather pesky case that won't go away easily. I also have collapsing arches in the same foot, so there's two things going on (maybe even a little Tarsal Tunnel Syndrome). I need a new foot... lol (sigh)
I went to a PT for achilles tendinitis/plantar fasciitis (associated w/ flat feet and another weird condition I have) who is a major league triathlete so she had real awareness of recovering athletic ability, not just being able to make it down to the cafeteria in the assisted living facility. She identified that my problem was not what our family doc thought it was and gave me different exercises I would never have found while scanning webmd on my own. Still took 6+ months, and fortunately for me the pain was associated w/ activities other than riding, so riding was a break from it rather than a contributor to it in my case.

And, oh yeah, I started using superfeet inserts in all my shoes.

Good luck.
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Old 06-05-15, 10:36 AM
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Here's a brief run down of what all I'm doing:
1. calf stretches: there's 3 or 4 variations I do of stretching, varying from leaning up against a wall (straight & bent leg) or on the floor
2. toe drops on stairs
3. tennis ball (mostly at work)
4. toe crunches: sometimes wading a towel up & sometimes just scrunching my toes (recommended by the physical therapist)
5. balance board: mainly at PT to help build foot strength. There's also what looks like a half ball thing I've stood on but can't think of the name of it)
6. swimming: when we take the kids to the pool about once a week, I'll often either try laps or just sit on the side of the pool kicking my legs. This really helps more building up a weak knee
7. new shoes: I did finally find a pair of work shoes (same model as what I've had for the last 10 years but took awhile to find another pair). My podiatrist likes these. Still looking for some sneakers and will look into crocs
8. diet supplements: Trying to get off the ibuprofen, I've been taking CuraMed (cucuramin/tumeric combination) and started on an Omega 3 supplement (need to get more, almost out)
9. night boot
10. foot exercises with what is essentially a big rubber band
11. cortisone shot (made things worse, not doing that again)
12. occasionally wrapping my foot (probably should more often)

As noted, I'm still trying to get an appointment to get custom fitted orthodics. The podiatrist thinks that will be the key to getting past this (honestly I'm skeptical as I've tried inserts before with no luck, but they were either off the shelf or semi-fitted by a doctor that I didn't get along with and I question her judgement... the current podiatrist said that was the wrong approach and we tossed them). The guy that makes the custom orthotics supposedly is an active cyclist so I'm hoping he can offer some insight as well.

I will say it has gotten a little better. The pain over the last few weeks has subsided some (though I still have painful days) and is more localized on my foot. Plus the physical therapist has said that the bottom of my foot doesn't feel as tight, but my heel is still very knotty. I go back to the podiatrist next week. We hadn't really talked about collapsing arches (that's something that runs in my family, so its largely heriditary) but I will bring that up. He'll probably want a set of x-rays. I had an x-ray taken when this was first diagnosed by my family doctor last fall but nothing was ever discussed other than it didn't appear I had any heal spurs or broekn.cracked bones.) I do appreciate all of the input and while discouraged and admittedly don't have the most optimistic outlook, I'm hanging in there and not ready to start selling bikes.

Last edited by bres dad; 06-06-15 at 07:59 AM.
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Old 06-05-15, 10:57 AM
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Originally Posted by bres dad
As noted, I'm still trying to get an appointment to get custom fitted orthodics. The podiatrist thinks that will be the key to getting past this (honestly I'm skeptical as I've tried inserts before with no luck, but they were either off the shelf or semi-fitted by a doctor that I didn't get along with and I question her judgement... the current podiatrist said that was the wrong approach and we tossed them). The guy that makes the custom orthotics supposedly is an active cyclist so I'm hoping he can offer some insight as well.
If you are skeptical, don't do it. Look at higher end inserts like superfeet the price-to-disappointment ratio will be a lot lower.

Also, the toe-drops off stairs that my family doc liked, my PT identified as making my problem worse. I am sure if you've got a PT who works w/ active people more than rehab patients they would have awareness of the range of possible problems you might have and would only have given you those if they were appropriate for you.
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Old 06-05-15, 11:37 AM
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Its interesting about the superfeet inserts, my podiatrist said toss them. He then suggested a more heel up position and some Power Step Pro Tech insoles for my regular shoes and nothing in my cycling shoes.
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Old 06-05-15, 12:44 PM
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I would get PF on and off for a decade. Pretty sure it was basketball related. Also developed very tender Achilles tendon. X-rays showed a nasty bone spur in the heel. Very painful. My orthopedic P.A. suggested I try 3 ibuprofen three times a day. I did that and it went away in about a week (probably less). It has not returned.

On a related note, I have never gotten any soreness in PF, Achilles or back from riding a bike (just bball). That's one of the great things about riding for me is that it doesn't injure my body like bball does.
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Old 06-05-15, 04:00 PM
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It's interesting some of the methods people are describing here since they're really trying for the in between approach which usually leads (in general, don't know each person's case) to a livable result. As they're doing a small amount of exercise/stretching but primarily going orthotics and other footwear just to alleviate pain and not actually fixing the problem with foot/ankle strength and flexibility. Kinda like how many people take heart meds instead of exercising and eating right and end up needing their crutch the rest of their lives. But that's up to the individual if that's acceptable or not as one's a lot harder than the other option.

OP: It seems like you're doing everything right with your current method. Orthotics and other specific footwear should ideally (again, ideal situation as you may need to be on your feet) only be used to prevent inflammation/swelling while you work on getting rid of scar tissue and increasing foot strength and flexibility. But this assumes that there's no damage or irregularities in your foot/leg/hip system that physically prevents normal function. Many of those who suffer from PT and high arches is because many people just can't walk properly today due to inflexibility and high drop shoes making up for their inefficiencies. Lots of people you'll see walking around duck footed (feet pointed outward) which effectively reduces the use of the foot arch and foot flexibility, ankle flexibility and forces your knee to track inward. So while foot exercises are good, changing your gait is also important if it needs correcting as that's something that will exercise/stretch every time you take a step.
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Old 06-05-15, 08:08 PM
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I had it bad after a marathon two years ago. Went to the podiatrist, got insoles, cortisone shot, and a night splint. None of that helped as much as starting to tape it with kinesio tape (Rock Tape). Worked like a charm. After a month or two, it went away.
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Old 06-06-15, 07:54 AM
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makeitso5005, you have good points. Overall I try to watch what I eat. Plus I'm not overweight (5'10- 150lb). The way I walk really was never addressed in this round of therapy (they specifically looked at my foot) but that was addressed a few years ago when I first got back into cycling. I originally had to cut back on riding & racing when I was in college due to knee issues 20 years ago. When I got back into riding a few years back I knew my knee would be an issue so I went straight to a PT. I think they were satisfied with the way I walk, foot position, etc. I was in a wreck as a kid that did some permanent damage to my left knee (it hyper extends about 2-3 degrees and is looser in general than my right, great for martial arts but a problem otherwise.) I've worked to build my knee back up (not as much as I should I admit) but a weak knee has always been an issue. The fact I haven't been out on a bike much this hear has taken its toll on my knee. I went out with my wife last night for a short 7 mile ride and I could tell my knee was considerably weaker than it normally would be (waiting to see if that ride has adverse affects on my foot, will know in the next day or so as it usually bothers me 24-48 hours after a ride, rarely right after). I guess where I'm going with this is I've always had problems with my left leg in some fashion. I've no doubt its all related.

I did forgot to mention that we were going to a sponsored ride about a month ago (it was a real disaster... we drove three hours, nothing was marked or laid out very well and couldn't find the start point let alone the course. Online registration was a nightmare and it got rained out.) We stayed with my cousin whom is a nurse and she asked if I was going to wrap my foot (she knew about my PF) and I said no. She did have any kinesio tape but used another wrap and that did help atlot. I mentioned that to the PT and she gave me some Kinesio tape to use at home. Probelm is if I leave it wrapped more than 24 hours all sorts of places start hurting in my foot that normally don't with the PF. I had been wrapping it from the inside to the outside (pulling down on my arches). THe PT showed me how to wrap it from the outside in (pulling up on my arches.)

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Old 06-06-15, 08:38 AM
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Didn't read all the posts but I have been a runner for many years and have had lots of different injuries- PF, although I've never had a severe case, has been greatly helped by rolling a golf ball (very gently at first) under the foot. My two cents, good luck!
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Old 06-06-15, 02:40 PM
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I got ride of mine a long time ago by never walking bare foot for a few weeks.

The key is to put shoes on with arch supports before you step out of bed, even if you get up for a piss.

In my opinion, a lot of us need arch support in out cycling shoes
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Old 06-06-15, 03:23 PM
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Second the golf ball. One of the keys is to break down the scar tissue that contributes to PF. My brother has suffered from PF for years, and has become an expert at treating it. The golf ball size is important because you want to apply pressure to specific places. The direction of massage is also important. Many muscles tend to get massage longitudinally; think The Stick and massaging leg muscles. With PF you also need to massage from side to side. Breaking down the scar tissue is very important. I had my PF flare up a month ago and following his advice have been much better. Also definitely ice.
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Old 06-06-15, 08:22 PM
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the golf ball trick works great for me too.
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Old 06-07-15, 05:25 PM
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Originally Posted by bres dad
makeitso5005, you have good points. Overall I try to watch what I eat. Plus I'm not overweight (5'10- 150lb). The way I walk really was never addressed in this round of therapy (they specifically looked at my foot) but that was addressed a few years ago when I first got back into cycling.
There's obviously quite a bit going on in your case so none of us here is going to have any idea of what the end all solution will be so I can just offer some ideas. Though one of my personal quips about podiatrists in general is that they will usually give out information with the basis on fixing the issue just enough that they can sell you products (be it special footwear, custom orthotics, specialized taping/wrapping solutions) to take you the rest of the way toward lessening pain. You could still be as disjointed as ever and not stable at all with the exception of those devices, as generally podiatrists aren't in the market of establishing correct gait/posture which ultimately usually will fix a lot of the issues but it's a lot more work going to a PT and fixing the issue(s) but ultimately you're better off if it's plausible.

Now... as for the other issues you brought up. First I'll put the disclaimer that I'm no expert on the subject, only someone who's run/biked a bit and does a bit of analysis overload of any pains or issues I've had but I've only had some minor PF issues in the past. With that being said I recall PF usually is caused by a) inflexible/weak feet/ankes/hips or knees b) a strain or inflammation in the area that never is allowed to fully heal or c) buildup of scar tissue in the PF area from previous issues or injuries. So just based on what you've said a and b are applicable but not sure about if you have scar tissue in there you need to break down since that makes a fairly distinct difference in what you can do. As with scar tissue in there you're always going to have to balance the amount you can break down without it resulting in inflammation. As inflammation is the priority to keep to a minimum. Though as others above have said, golf balls and other stiffer materials are more ideal for breaking down scar tissue and are easier to control the direction they move across the PF band.

The exercise routine you're doing seems spot on for increasing muscular strength as you've got some directed large muscle workouts, foot dexterity exercises and some bosu ball small muscle balance exercises as well. It wouldn't appear that strength (in regard to your routine) should be an issue. The only thing not really addressed in what I've read is your flexibility. Just on the regard to your gait, one very easy test to determine which way you push off your feet is to stand with your feet slightly narrower than your shoulders ensuring your feet are pointed straight forward. Then do a squat as far as you can go down comfortably while keeping your feet pointing forward. Your knees will track based upon how you normally (most worn direction) use your ankles. If your knees go inward you're likely walking duckfooted and if the knees go out you're walking pigeon toed. But this is just one indicator test to help determine how you're using your feet and legs normally. Though keep in mind that I'm in the camp that it's flexibility before strength as if you don't have the flexibility to achieve the range of motion needed all the strength in the world isn't going to help. Though I do realize this isn't PF specific, it may help target some areas that might need addressing. Posture Power: How To Correct Your Body's Alignment - Bodybuilding.com

As for how to tape your foot with or without KT tape I can't offer much advice. I'm still not fully sure if I believe taping the overlying skin can offer meaningful structure to the joint underneath (won't get into that here). Though I don't doubt that taping something up for 24 hours is going to hurt as you're now introducing a new constant pressure stress in the opposite direction of normal. So while it may take pressure off the PF area it adds it in other areas of the foot. I wouldn't recommend doing any kind of tension/compression based wrap on a day long basis unless a doctor approves it prior. Most of these types of things are done to take stress off the single point and spread it to the surrounding area irregardless of if those areas are designed to accommodate load in that direction as it's done to temporarily reduce pain/weakness at the one site by spreading the load. Bottom line: Perform as needed to get you through the activity then take it off - especially if it causes other pain.

Hopefully I offered a few ideas to take off to help with your PF issues. It's one of those issues that's the most frustrating since it can linger for what seems like forever.
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Old 06-07-15, 06:13 PM
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The one thing I have yet to see mention are Birkenstocks. Yes, they are ugly. But they are great for PF. (and fallen arches and so on) The foot bed is designed to realign and strengthen the foot bones and muscles.

Thing is they take a week or so to get used to.
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Old 06-07-15, 08:23 PM
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I have had PF and since I am a urologist I also have some knowledge of shock wave therapy. Shock wave therapy is used because part of the cause of PF is bone spurs. It is apparently successful in some cases but not all, the problem is it is not covered by insurance and therefore rarely used, cost is 5-10K. Our kidney stone center actually owns a PF shock wave machine, very rarely used.
When I had pf I tried special shoes, ankle support to keep my arch pulled up, shoes with better support in them. I NEVER went barefoot(per my pod instructions) and religiously used the night boot. I think the night boot is very very important because if you don't use it, your plantar fascia contracts at night, thus leading to someone sticking a lit match under your foot when you first step down in the morning and rapidly stretch(aka tear) it back. Mine interestingly didn't bother me that much when cycling, perhaps cleat position may help with that, moving cleat as far back as possible on the shoe(which mine just about are). Thankfully mine eventually went away, I am careful now to do preventatives such as stretching, not wearing shoes with little support, don't go barefoot much or wear flip flops a lot. Best of luck hope you get well
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Old 06-17-15, 02:10 PM
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I am pretty sure bone spurs are different and a dx on its own. PF is the scarring of the plantars tendon or ligament. Usually caused by a collapsing arch. Birks are not ugly and the most comfortable foot wear one can own, but the arch support is in the wrong spot and will not help PF.

I suffered from this too, all the classic symptoms and causes. Morning foot pain radiating from the heel, gained too much weight, always being barefoot, etc.

I tried the oral cortisone and stretching, no luck. What finally did it for me and it has been gone for close to two years was a cortisone shot, powerstep orthotics, sneaker fitting by a reputable run shop, and always wearing shoes.

It started to come back after switching from powerstep to sure feet and gaining a little weight back. I was fitted for new sneakers and put in a new pair of powerstep orthotics. The world is right again.
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Old 06-18-15, 07:48 PM
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I've had PF six times, from age 23 to 51. I got it from running every time, and I switched to barefoot running eight or nine years ago, and that took care of getting PF from running--although I did get it two more times from running or jumping in shoes.

I have a bias against podiatrists, who don't seem to really know how to treat PF very well. Many have told me I should never go barefoot and certain never run barefoot, but it has worked for me. But while I have PF, what has worked is this:

--wearing a night splint to keep the fascia from shortening and healing in a shortened position overnight. The night splint is NOT for stretching your achilles, if you set it for that much stretch, you'll rip the thing off after a few hours. The purpose is to prevent you from pointing your toes, which results in the fascia partially healing in a shortened state, which tears immediately when you first put weight on your foot in the morning.

--what I call "foot yoga", which involves using your own arch muscles as much as possible to hold your foot in an arched state while walking. I wear the most minimal shoes I can, often simple moccasins, and concentrate on holding that arch muscle tension with each step. This alone has cured my PF the last two times, in only two weeks.

After your PF is cured, go barefoot as much as possible to develop arch strength.

I found orthotics, stretching, ant-inflammatory medications, icing, and all the rest of the typical remedies to be utterly useless. Just my two cents, but I'm talking from decades of experience with this ailment.
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Old 06-18-15, 07:56 PM
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I had PF multiple times. It takes a really long time to completely resolve.
The best relief I have had is to use an ice cup like this one:

Amazon.com: Cryocup Ice Massage Therapy Tool: Sports & Outdoors

At work, I roll a lacrosse ball under my feet (not too much pressure) while sitting at my desk.

Also don't be shy about changing insoles. There is a company that makes custom cycling insoles but I would not get one made until your feet have healed.

On the MBT, I am a size 43 and I have two of those. If you are interested, shoot me a PM. I will gladly sell you one.



Bora
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Old 06-23-15, 07:45 AM
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There appears to be some progress. Still waiting to meet the guy that makes custom orthodics & inserts. I saw the podiatrist last week and he noticed a difference in my foot, not as tight or stiff. While he's not declaring victory he's saying a lot of progress has been made and setting an appoint me for September instead of mid July as originally scheduled.

He said I can start biking but be cautious and not over do things or I'll be right back where I started. Having that said, about 5-6 miles is as far as I've been able to go and my foot will be in pain the next few days. I went out 10 miles over the weekend and 8 last night with maybe slightly more than usual discomfort which is a noticeable improvement. That's more than I've rode in the last month. Taking tonight off and weather permitting, will head out & do some mountain biking tomorrow. Feels good being back in the saddle.
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