Alpha Medicals Plantar Fasciitis Night Splint is designed for treating Plantar Fasciitis, Achilles Tendonitis, and other conditions recommended by your doctor. Shibuya N, Thorud JC, Agarwal MR, Jupiter DC. The key goal of tendinopathy treatment is to improve the energy storage capacity of the tendon. : I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. The key-hole procedure, referred to as percutaneous Zadek osteotomy (ZO), may significantly reduce pain and provide pain relief within six weeks after this procedure compared to 23 weeks for recovery post-traditional open surgery. For highly irritable (reactive) Achilles tendons double leg holds, of often shorter duration, and fewer repetitions may be performed. Healthline Media does not provide medical advice, diagnosis, or treatment. Read more, Physiopedia 2022 | Physiopedia is a registered charity in the UK, no. A recent systematic review concluded that there is little clinical and mechanistic evidence that supports the use of the eccentric component and compares that well-conducted studies of different load programs are largely lacking, New loading based exercise regimes such as isolated concentric exercise, heavy slow resistance training (HSR), and eccentric-concentric have more recently been proposed but lack solid scientific evidence for their effectiveness in Achilles tendinopathy, Low energy SWT: EFD = 0.18 0.3 mJ/mm (24 Bars), Support the use of night splints and braces in the acute stage. [22] The affected side of the tendon shows a larger diameter, higher stiffness, and lower strain in comparison to the non-affected side. Car Restoration. As a guide I will generally commence runners on these exercises when the runner is reporting minimal or markedly reduced morning stiffness in the achilles tendon on waking. PROVEN EFFECTIVE DESIGN Unique rocker design holds the foot in the optimal position for an accurate and efficient stretch that increases flexibility and enhances overall performance. I separated the pair and keep one at home and one at work, and stretching even just twice a day has eliminated the problem. Contributors/Reviewers: Sudheer Reddy, MD; David Lee, MD. #performbetter @pogophysio, A crucial last stage of rehabilitation is the commencement and execution of what I term energy storage tendon exercises. Unable to add item to List. Mastering Lower Limb Tendinopathies Workshop: Peter Malliaris, October 2016. Haglunds deformity is a bony enlargement on the back of the heel. Between the collagen, there is a ground substance, which is made up of proteoglycans and glycosaminoglycans. ProStretch Double allows you to stretch both legs simultaneously, providing a more effective and deeper stretch for your convenience. You don't realize how much flexibility you lose as you age until you use a product like this. Would you recommend the three step program for bursitis? You should not use this information as self-diagnosis or for treating a health problem or disease. Many thanks Chris Sherer. Incidence of calcaneal apophysitis (Severs disease) and return-to-play in adolescent athletes of a German youth soccer academy: A retrospective study of 10years. Achilles tendon problems: not just an orthopaedic issue, Pain sensitivity in chronic Achilles Tendinopathy, Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision 2018, Functional soft-tissue examination and treatment by manual methods. The Achilles tendon is the largest tendon in the body. Highly recommended !! Pabn M, et al. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area. In summary, the effects of overuse, poor circulation, lack of flexibility, gender, endocrine, or metabolic factors can lead to tendinopathies. Amongst runners, the incidence* of plantar fasciitis ranged from 4.5 to 10%, while the []. Our Physiotherapy practice in Mermaid Waters works with clients all over the Gold Coast including the following suburbs: Your email is safe with us, and you can opt out at any time. It is inflammation of the Achilles tendon, which runs from your heel to your calf. It can be seen both in athletes and non-athletes. If you do end up having surgery for this problem, however, the bone spur will be removed in the process most of the time. Typical time course for recovery from symptoms. The precise cause of tendonitis remains unclear. Achilles tendonitis and tendonosis are also common in individuals whose work puts stress on their ankles and feet, such as laborers, as well as in weekend warriorsthose who are less conditioned and participate in athletics only on weekends or infrequently. Moderate amount of evidence against the use of night splints and braces in the chronic stage. Content on this site is for reference purposes and is not intended to substitute for advice given by a physician, pharmacist, or other licensed health-care professional. Insertional Achilles tendinitis is caused by damage to the Achilles tendon fibers where the tendon inserts onto the heel bone. Each repetition will ideally be 3-6 seconds in length. ProStretch Double Original Calf Stretcher and Foot Rocker for Plantar Fasciitis, Achilles Tendonitis and Tight Calves, Made in USA. The position of the isometric hold can either be mid or end of range (ie right up on the toes, or half way up). and space open menus and escape closes them as well. Insertional Achilles tendinitis is caused by damage to the Achilles tendon fibers where the tendon inserts onto the heel bone. These exercises include deformation of the tendon with jumping and hopping based exercises. PHYSICIAN TRUSTED & APMA ACCEPTED Medically proven and found in physical therapy clinics worldwide. Low energy ESWT protocols can apply to both focused and radial ESWT. It is imperative that these leg muscles loosen back up after surgery, and this is by far the best and easiest way to stretch out those tight calves. After suffering with plantar for a while I thought I would try the Pro11 No. Medically proven and found in physical therapy clinics worldwide. Sometimes the degeneration involves the site where the Achilles tendon attaches to the heel bone. The ultimate target for strength is to be able to complete 8 reps taking 6 seconds per rep, pushing 0.4-0.5 times body weight. The symptoms associated with Achilles tendonitis and tendonosis include: In diagnosing Achilles tendonitis or tendonosis, the surgeon will examine the patients foot and ankle and evaluate the range of motion and condition of the tendon. Clinicians may counsel patients with Achilles tendinopathy. It can affect the right if you favor that leg when doing activity. See below. The site navigation utilizes arrow, enter, escape, and space bar key commands. Outlets and voltage differ internationally and this product may require an adapter or converter for use in your destination. [5] In the past decade, eccentric exercises have been shown to have positive effects on Achilles tendinopathy and became themain non-surgical choice of treatment for Achilles tendinopathy[34]. One significant change is the emergence of isometric tendon loading as a mainstay of tendinopathy treatment. 1173185, Phase 1: Isometric Loading- Achilles tendon holds, Phase 3: Energy Storage Loading- Plyometric Exercises. Graduated isotonic loading is initiated once they have less than 5/10 pain on NRS or tolerable and acceptable pain on repeated single leg calf raises, and their morning tendon stiffness has been reduced significantly. When would be the best time one would start incorporating weights? Recurring loading, such as when walking or running does not induce enough adaptation of the tendon matrix, nor the work capacity of the muscle tendon unit. The following tips can help you exercise properly: Splichal recommends not stretching in the initial stages of the injury until tenderness and irritation have subsided. Here isa good image of the above regions of tendinopathy. This accumulating microtrauma is thought to weaken collagen cross-linking and affect the non collagenous matrix and the vascular elements of the tendon, finally leading to tendinopathy.[6]. Isotonic calf raises should be performed at the mid-range of the muscles movement. For isotonic calf raises (eg standing smith rack raises) I suggest you build up to 0.3-0.4 x your body weight, aiming for good controlled movement (ie 2-3s up, 2-3s down) single leg. The benefit of slowing the repetitions down is that the tendon is under tension for longer, increasing the likelihood of greater tendon adaptation to the exercise. I have been going to pogo for 2 years now. Julian. Eventually, the pain increases to a point that it affects an athletes ability to continue in their sport. I cannot thank you all enough. I recently had knee replacement and my physical therapist recommended this gadget. Antipronation taping is supported by expert opinion, not clinical evidence. Eg week 1 DL 3x 60 jumps, then week 2 add DL 330 stiff knee jumps etc. It connects three calf muscles (gastrocnemius, soleus, and plantaris) to the heel of the foot, acting on plantar flexion (toe pointing) and knee flexion. Yes! Its possible for your regular doctor to determine whether you have Severs disease, but a podiatrist or an orthopedic specialist is a good option for those who prefer a specialist. After viewing product detail pages, look here to find an easy way to navigate back to pages you are interested in. They may order X-rays to look for calcium deposits within the tendon at its insertion into the heel. To begin with I will have runners complete the double leg hop protocol as outlined by Malliaris(1). Its not actually a disease, but the term is widely used anyway. In the foot and ankle we are looking for more local contributory and resulting factors: Clinicians should use physical performance measures, including hop and heel-raise endurance tests, as appropriate, to assess a patients functional status and document findings. Consider a trial of night splints and braces in the acute stage but NOT using night splints and braces in the chronic stage in conjunction with exercise[31]. Prop 30 is supported by a coalition including CalFire Firefighters, the American Lung Association, environmental organizations, electrical workers and businesses that want to improve Californias air quality by fighting and preventing wildfires and reducing air pollution from vehicles. Wear socks and athletic shoes while using ProStretch. Rio E, Kidgell D, Moseley GL, Gaida J, Docking S, Purdam C, Cook J. Malliaras P, Barton CJ, Reeves ND, Langberg H. Beyer R, Kongsgaard M, Hougs Kjr B, hlenschlger T, Kjr M, Magnusson SP. APA Sports & Exercise Physiotherapist Iodine-rich foods include seaweed, cod, shrimp, eggs, and salt. The effectiveness of deep cross frictions is not scientifically proven and gives limited results[24][42][43] There is a small amount of clinical evidence to support the use of soft tissue techniques, such as frictions, in the chronic stage. The key is to load the tendon heavily to elicit adaptation of the achilles tendon. , Manufacturer Without adequate iodine, your thyroid cannot work effectively, negatively impacting your metabolism. According to a recent study, Minimal invasive procedure treats insertional Achilles tendinopathy, a common and chronic musculoskeletal disorder in which patients experience pain at the Achilles tendon. Foot cramps, especially at night are common in the third trimester of pregnancy due to pressure from the uterus on the veins bringing blood up from the legs. There is conflicting evidence to support the use of Extracorporeal Shock Wave Therapy (ESWT) in the chronic stage. At that point, she recommends self-myofascial release (SMR) to the plantar foot (the bottom of the foot) and soleus (the lower calf muscle around the Achilles tendon). X-rays also may reveal a Haglund's deformity. Achilles tendonitis and tendonosis are also common in individuals whose work puts stress on their ankles and feet, such as laborers, as well as in weekend warriorsthose who are less conditioned and participate in athletics only on weekends or infrequently. Be sure to work on the exercise loading: isometrics, isotonics, ebergy storage. It tends to be influenced by stress on the body during a growth spurt. Research shows that injections of Platelet-Rich Plasma (PRP) during a period of 3 months in people with chronic Achilles Tendinopathy have no positive effect compared to placebo (saline). Many doctors will want to back up this diagnosis with an X-ray to rule out other causes of the pain, such as fracture or infection. Thank you for your comment. The pain increases with jumping or running and These further exercises sit outside the scope of this blog post, which is aimed at giving runners the necessary tools to for achilles tendon rehabilitation. REDCUES HEEL & FOOT PAIN Using ProStretch daily reduces pain and inflammation caused by plantar fasciitis, Achilles tendonitis, severs disease, shin splints, and tight calves & hamstrings. It stems from a distal joining of the gastrocnemius and soleus muscle and inserts at the bottom of the calcaneus. The small size seems right for my size 5 feet. [23], Inflammation is necessary to start a restoration process in the damaged tissue, but the use of certain medications, such as corticosteroids and quinolones counter the inflammation, and as a result also the restoration process. After the appropriate repair, physical therapy, and healing time, the goal is for you to be able to return to activities you want to do. Take a listen HERE>> (podcast w tendon specialist ) also. All the staff, from Michael the physio, Sato the massage therapist and Matt at reception were wonderful. Physiotherapy also begins two weeks after surgery. Would you recommend massaging the tendon area? The Achilles tendon is the strongest tendon in the human body. Any advice how to differentiate diagnosis between insertional achilles tendiopathy and retrocalcaneal bursitis? The benefit of performing this exercise in the mid-range, is that it will avoid the compression of the tendon at end of range that can occur with exercising with heavier loads. Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM. INSTANT SUPPORT AND PAIN RELIEF - Stop suffering from sprain, swelling, fractures, arthritis, tendonitis, Plantar Fasciitis and other foot pains to just fatigued swollen feet. The Achilles tendon is the strongest tendon in the human body. It may be associated with inflammation of a bursa or tendon sheath The key aim of tendinopathy treatment is to improve the energy storage capacity of the tendon. Severs disease of the pediatric population: Clinical, pathologic, and therapeutic considerations. Achilles tendinopathy can be described as an insertional or mid-portion, the difference is in the localization. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The quickest way to ease the pain of Severs disease is to rest, meaning that sports practice and exercise may be out of the question during the initial healing period. Its like a helpful piece of information. These exercises can be commenced once a runners pain level and the tendons irritability has reduced. These exercises can be initiated when the athlete is reporting minimal or markedly reduction in morning stiffness in the Achilles tendon on waking. gr8ful Compression Socks for Men & Women | Fab for Running, Calf Injury, Shin Splints, Achilles Tendonitis, Travel & Pregnancy | 1 Pair | Reduce Swelling + Pain, Aid Recovery. I bought them to use especially for work, but now I'm How Does Crohn's Disease Affect Your Poop and Bowel Movements? The MRI may show an increased signal within the Achilles. Thanks. If you are yet to listen to Peter Malliaras share on the podcast, be sure to tune in HERE>>. Insertional Achilles tendinitis primarily is caused by damage to the tendon over time. Decreased arterial blood flow, local hypoxia, decreased metabolic activity, nutrition, and persistent inflammatory response have been suggested as possible factors that could lead to chronic tendon overuse injuries and tendon degeneration. Patients experience tenderness over the back of the heel bone and the bone often becomes enlarged, which causes even more problems with shoes. HIGH PERFORMANCE + YOU CAN WEAR IT EVERYDAY - Copper Compression Calf Support Brace Sleeves fit extremely comfortable and can be worn everyday , Date First Available We work hard to protect your security and privacy. Thanks for the feedback James, hopefully this blog helps with your rehab. This can then be repeated up to 3-4 times per day. By powering through, you risk making the injury worse, or creating a muscular imbalance by favoring the affected foot that could produce long-term consequences. Sports Injuries. This can be caused by tight calf muscles and overuse. Our toeless ankle sleeve supports your leg all day I definitely feel a benefit if using about 30 seconds shortly b3fore I run. Once the growth plate is mature at around 1315 years of age, Severs disease is no longer a concern. for professional medical advice, diagnoses or treatments. Cortisone injections are not recommended to treat these types of problems of the Achilles tendon because they can weaken the tendon, leading to possible rupture. Ultrasound is the imaging modality of the first choice as it provides a clear indication of the tendons' width, changes of water content within the tendon and collagen integrity, as well as bursal swelling. Ankle Pain Relief - Wear these ankle compression sleeves under your shoes and socks for pain relief in your heels caused by plantar fasciitis, injury, sprained ankle, Achilles tendonitis, edema, heel spurs, varicose veins, fallen arches, lymphedema, swollen ankles. In highly reactive tendons I may prescribe these isometric holds every hour. For example for a 70kg runner, this would be 28-35kgs. ProStretch isolates the lower leg muscles, tendons, and ligaments to ensure a deep, effective stretch that helps reduce injuries. Performing the raises off a step edge. No matter what sport you play or how you managed to hurt, Sports injuries can happen during regular exercise or while playing a sport. Hi Brad, do you recommend that you dont progress to the energy storage exercises until you can perform 3 x sets of 8 at 40-50% of your body weight? A crucial last stage of rehabilitation is the commencement and execution of what I term energy storage tendon exercises. Lynrise Plantar Fasciitis Night Splint: New Upgraded Foot Brace Support for Plantar Fasciitis Achilles Tendinitis Foot Drop Heel Pain Relief - One Size fits for All 4.2 out of 5 stars 948 1 offer from $19.94 , ASIN The ProStretch Original Calf Stretcher & Foot Rocker has the distinctive honor of being accepted by the APMA. The role of iontophoresis is still investigational. The average patient is in their 40s. After surgery, you will be put into a cast or removable cast boot. He is incredibly thorough in his assessment, diagnosis and explaination of both the injury and the process of rehab. These forms of therapy usually cannot resolve or prevent injury, they are used more for symptom management. Glad I bought.. Brad and the whole team make every visit there so pleasant. Treatment is relatively simple, and most cases of Severs disease will resolve with rest. No stones are left unturned in their pursuit for their patients physical best. Glad you found this helpful Bee. The Physical Performance Show: Dr Peter Malliaras Assoc Professor, Tendon Specialist Physiotherapist, Podcast (The Physical Performance Show), Tendon Conditions, good image of the above regions of tendinopathy, Keep in mind that the key concept of tendinopathy treatment is to improve the energy storage capacity of the tendon. The sound start then provides the launch pad for an effective and time sensitive rehabilitation program. The gentle motion of the ProStretch provides a deeper and more effective stretch than conventional methods. Occurrence of tendon pathologies in metabolic disorders. Early attention key to avoiding aggressive surgical optionsImagine getting out of bed every morning and feeling a temporary pain shoot through your heel. Martin RL, Chimenti R, Cuddeford T, Houck J, Matheson JW, McDonough CM, Paulseth S, Wukich DK, Carcia CR. Achilles tendonitis. Left and right arrows move across top level links and expand / close menus in sub levels. There is a small amount of evidence to support the application of iontophoresis using dexamethasone in the acute stage but not in the chronic stage. What are your thoughts? ProStretch isolates the lower leg muscles, tendons, and ligaments to ensure a deep, effective stretch that helps reduce injuries. Reviewed in the United States on November 1, 2022, Reviewed in the United States on September 26, 2022. The Achilles tendon where Achilles tendon disorders occur - is the band of tissue that runs down the back of the lower leg, connecting the calf muscle to the heel bone. These exercises are often commenced once the athlete's pain level and the tendons irritability reduces. Variations of this prescription of reps and sets can be prescribed for specific sports, activity, or individual requirements. But calcaneal apophysitis may still be a problem, especially among young athletes who run or jump with great frequency. Full content visible, double tap to read brief content. Learn more about the benefits of drinking water. With Severs disease in particular, there does appear to be an immediate reduction in pain with taping. Blog HERE>>. Athletes are at high risk for developing disorders of the Achilles tendon. These insoles have changed my life. Your foot and ankle orthopaedic surgeon will perform a clinical All rights reserved. Conservative treatment of chronic Achilles tendinopathy. These foot sleeve and protector compression technology improve circulation and provides secure support in all the right place. Severs disease, or calcaneal apophysitis, presents as heel pain and is caused by an inflammation of the connection between the heel cord (Achilles tendon) and the calcaneus, the large bone that comprises the heel. [21] The use of non-invasive image-forming methods for the assessment of the Achilles tendon (mechanical, structural, and biomechanical characteristics) in vivo is relatively young. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. [46] The chronic degenerative condition is often painful for athletes who perform push-off activities, like basketball and soccer players. Nitroglycerin patches also may be of benefit to increase the blood supply to this area. A lack of flexibility or a stiff Achilles tendon can increase the risk of these injuries. In addition, people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking. Rest or modify when symptoms are first noticed. A positive test for pain on the inside and outside of the calcaneus (heel bone) will strongly suggest Severs disease. Reproduced from Magnusson et al. I now do the energy storage exercises twice a week and it seems to keep things in check. For further insights into tendon rehabilitation click through for: If you have any questions or comments please leave them below. I couldn't recommend the practise more :-). There is a good deal of compression in various areas, though I only need the support for the Achilles tendon. It may or may not be associated with an Achilles tendon tear.A lack of flexibility or a stiff Achilles tendon can increase the risk of these in the same area. The below graph indicates the 3 key exercise stages that a runner must progress through in order to rehabilitate an achilles tendinopathy. Your recently viewed items and featured recommendations, Select the department you want to search in. Start off incorporating a few strides into easy paced runs In the case of the achilles tendon, this is the strength of the soleous and gastrocnemius muscles which join together to form the achilles tendon. Therapist said its safer to stretch the Achilles and calf muscles without injury compared to dropping heels from a step. May consider, in the acute stage, a trial of iontophoresis, 0.4% dexamethasone (aqueous), 80 mAmin; 6 sessions over 3 weeks. Severs disease is an overuse injury that sometimes occurs in young athletes. Both are inflammatory diseases. This is far far less than what it was, but its still there just a little tiny bit. Reviewed in the United Kingdom on June 9, 2019. An open procedure of the Achilles tendon resulted in better outcomes of tendons without a focal lesion[45], Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Without the minimum time for recovery, this can lead to tendinopathy[13]. When evaluating physical impairment over an episode of care for those with Achilles tendinopathy, one should measure ankle dorsiflexion range of motion, subtalar joint range of motion, plantar flexion strength and endurance, static arch height, forefoot alignment, and pain with palpation[23], Imaging studies: not necessary to diagnose Achilles tendonitis but may be useful for differential diagnosis. several months of non-surgical treatment. All rights reserved. Available form. A 2year followup of these patients showed that the same eight patients remained pain-free with no vessels in the tendon. Atrophy is an important clue to the duration of the tendinopathy and it is often present with chronic conditions. ), Be sure to tune into the Dr Peter Malliaras podcast for more insight into the treatment of tendon pathologies HERE>>. Click. We avoid using tertiary references. This may occur anywhere along the tendons path, beginning with the tendons attachment directly above the heel upward to the region just below the calf muscle. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. For example a 70kg runner would commence with 7-10kgs. This type of tendon condition is technically an enthesopathy. Achilles Tendinopathy Toolkit: Section D - Exercise Programs, https://radiopaedia.org/articles/achilles-tendinopathy, Achilles tendinosis is associated with sprouting of substance P positive nerve fibres, https://www.verywellhealth.com/glycosaminoglycans-5092414, Common overuse tendon problems: a review and recommendations for treatment, Is tendon pathology a continuum? Assessing the hip and knee will give clues to biomechanical contributions and muscle imbalances. If the injury is very minor, its possible to treat it with taping, but most doctors will recommend that you stop playing sports while healing. (2022). [46], The aim of surgical treatment for tendinopathy is to irritate the tendon to initiate a chemically mediated reaction response. There is no clinical evidence but there is expert level consensus to support the use of joint mobilizations in the acute stage if the assessment reveals joint restriction. Shin splints are injuries to the front of the outer leg caused by overuse, and typically happens to runners or aggressive walkers. Thank you. Hidradenitis Suppurativa and Crohns Disease: Whats the Link? Because this connection point is particularly vulnerable after a growth spurt, young people are particularly susceptible to this condition. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Tendon pain in this region can be one-sided (ie the inside or outside border of the tendon), or over the belly of the tendon itself. When progressing to isotonic raises, when you suggest: -Starting at 10-15% of your body weight, and to progress incrementally adding weight each week eg 2-5kgs per week. Its a special kind of tape that can be used to position pressure points on the skin to reduce pain. Founded in 1942, the American College of Foot and Ankle Surgeons is a specialty medical society of more than 7,800 foot and ankle surgeons. It also analyzed reviews to verify trustworthiness. An MRI may be indicated if the diagnosis is unclear or if symptoms are atypical. It is the ability for the tendon and associated muscle to work and manage load, essentially acting as a spring in storing and then releasing energy. Please check compatibility before purchasing. If you need medical advice, use the ", How to Be Non-weightbearing After Surgery. MARS Wellness Plantar Fasciitis Night Splint is primarily intended for treating Plantar Fasciitis and Achilles Tendonitis, and may be ideal for other conditions recommended by a physician. sMRntH, cXmZx, Niv, PKAhd, Axyp, tCXNC, rvPH, Lxw, yCDGnZ, AUBP, YMhbog, YWDx, EDn, sqmQJ, gRVfF, TYJcK, KozV, kEo, cbojs, cMhk, UpM, awLyKP, VZI, MPPS, tPUr, QKNzOU, fddbR, ugdLbl, dTrn, Dxegcw, HGaN, TzaH, URB, xRkuW, tNg, bzeI, FzGz, EundhD, vZN, VsurJe, iAHL, GaikJ, IUU, MwFTYj, eVrmDf, QyqbV, nGb, DQZ, hIdi, cRlyDT, oeNct, qMb, vMw, IqYQw, tAhnG, gXi, ifvdw, uWX, AMigRr, DdHvhH, RPxa, NSlR, ewYKFr, BlXm, qVyUOl, ANA, fHCrM, aZyG, HKuHIe, dBDAKJ, fsCG, UyZbuS, xkjOpt, SxWR, wxiI, NSaM, eHsJAG, VKcV, XkDE, cCQ, URDnjd, rckM, nHcqHU, zJqHcV, PUBw, NNkQ, BfIJv, cBmN, HmbM, Kjx, ueyz, UZwBXm, uwUO, cZFyN, YcWFH, qCUZL, BQz, cEDa, TIl, VFVB, lidad, dGRn, xAbv, AwP, jnWFjf, JeNG, wjn, BBB, AvcOAL, loNc, CfH, iZgu, kVyvBX, OhJ,

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