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Ac Separation (shoulder Separation)

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#1 ·
I Recently Went Down Hard And Suffered A Grade 3 Shoulder Separation. I Am 5 Weeks Into This Injury And I Am Treating It Conservitively (non-surgical). It Is Very Frustrating Being That You Would Think This Injury Should Be Repaired Through Surgery But All The Doctors Are Telling Me To Leave It Alone And Physical Therapy It. I Am Also An Active Weight Lifter. I Used To Bench Press 340lbs And Now I A Struggle With 50lbs. I Know It's Only 5 Weeks Into The Injury But I Am Not Sure Where I Should Be At As Far As Lifting Weights And What's The Road Ahaed Of Me Going To Be Like Being That Is Being Treated Non-surgical. Any Info Would Be Greatly Appreciated!!!
 
#793 ·
I too suffered a serious Grade 3 to my left shoulder. I just reached 5 weeks yesterday. I've been playing hockey for 34yrs and this is my first injury (knock on wood), so obviously it scared me. After reading several posts in here my mind is at ease that I will have a full recovery without surgery. I have a very significant bump on the top of my left shoulder from my collar bone being pushed up. I started physical therapy just over a week ago and I can barely lift my own arm without significant shaking. I have minimal pain 5 weeks in, but my range of motion is not back to normal yet (hopefully soon).

I saw an Orthopedic Doctor who treats the local AHL Hockey team affiliated with the Calgary Flames and he said they typically do not perform surgery and most, if not all of the players have full recoveries. I was told that 8-12 weeks I could be back on the ice with no lasting effects of the injury (other than the deformity on my shoulder).

Thanks for this forum to setting my mind at ease.
 
#794 ·
you could be back on the ice now..... but dont hit it again while its not healed!!! or you'll start all over again. you'll feel the occasional twinge now and then for months, thats the sign that says back it off a bit. when the twinges go from now and then to "doesnt happen anymore" i consider it fully healed. its what/how far/hard you push it in-between that determines the length of recovery time, in my opinion.

im a carpenter and own my own business, i pushed it everyday at work and then trying to keep my legs mtb'ing. it prolonged my recovery. if i had a desk job and only pushed it riding, i feel it would have been a little quicker. but it is what it is. about 8 months for me. dont rush it man, and pay attention to the "signs". get better!!!
 
#795 ·
I suffered a grade 3 separation about 4 weeks ago after I went over the handlebars with my full weight directly down on the point of the shoulder.

So far, so good. My doctor advised against any surgery, and, like others here, I know I'll have the bump now which really isn't so noticeable unless I point it out to people.

I've been doing basic band exercises my doctor showed me (arm straight up, sets of 10: pull forward, rearward, and then each side, repeat), which makes the shoulder feel great.

Are there any specific exercises anyone here has noted helps them the most in terms of strength and ROM? Thanks in advance.
 
#796 · (Edited)
Grade 3+ sep

Hello fellow bumpy shoulder peeps!

So my story goes as follows. Approx 5 weeks ago got a grade 2 on my road bike. Got pretty down and was starting to get depressed due to pain, discomfort, realization of permanence of appearance and all the other fun things that go with this injury. Two weeks later got a dream job on the water as a bartender a block away (make 3x what I used to as a cook). Bump went down, got back to biking, hiking, jogging, surfing and playing guitar. Put injury behind me. I wish I had continued to read this forum...

A week ago riding some neighbor kids kicked a basketball out in front of my tire and it hit perfectly to where I got speed wobbles and crashed. Now I've graduated to at least a grade 3 (I suspect it might be 4 due to the fact my shoulder blade sticks out my back somewhat and collarbone has vanished. My neck is hurting like hell and have constant muscle spasms in my shoulder blade. Of course the pain is pretty bad (still about a 6/10) and everything in that area feels out of place. The lump and droopy shoulder are really messing with my mind as I now look like a circus freak. The hardest part is dealing with fact that I just feel physically of balance. I can handle the pain but the thought of one side being different than the other is really disconcerting.

After reading this forum quite obsessively for the last week or so I have compiled a broad overview of surgery v. Non surgery routes. There are many variables with both sides (ie types of surgeries, PT excercises, Dr. Advice, degree of injury, etc) so my findings might differ from someone else's.

I have found that (approximately) with the non surgery route 27 were mostly pleased, 12 were mostly unhappy, and 16 were split (due to either not full recovery or dissatisfaction from appearance). 3 eventually bit the bullet and got cut.

The ones that went the surgery route were as follows. 39 were happy, 3 were not and 3 were split. The ones that weren't happy suffered complications from surgery such as infection, nerve damage, and or loss of ROM/strength. All of them stated that the surgery was incredibly painful and recovery time was slow/tedious.

I have state funded insurance so the treatment at the hospital is hardly top notch. Met with a specialist 4 days after the grade 3 and he asked what I do for a living. I told him bartending and was sort of dismissive saying I'll be fine with time. I explained that tending bar is somewhat laborious being that I have to move full kegs in and out coolers, grab cases of beer from walk in, and reach for bottles at above head height. He then suggested fixation. I go back in 4 days to decide.

As much as I would like to just deal with the pain and go back to work, resume bike riding/hiking/guitar playing, avoid surgery and all the details with that (there's a lot), I think I'm going to go for it my insurance covers it (come on Obamacare)!

My questions are for those of you that went with non surgery,
How long did it take before you felt your body "normalize" to a more even balance?
Did the bump (more like a lump) go down after you recovered?
Do you worry about falling on it again?
(Could it get much worse like collar bone getting into the neck or lungs)
Those with surgery
What foods/diet worked best for recovery?
How long did the pain last from surgery?
What were risky movements post surgery that could snap ligament?
What devices are beneficial to recovering quickly and comfortably?

This is a really tough injury both mentally and physically. I was really depressed the first week and pray to the universe that can scheduled next week for an op. I going to just stay positive, proactive and hope for the best because that's all I can really do right now. I Know It Will Get Better. It can't rain forever;)

Decided against surgery after all. I didn't want to lose my job and and prolong recovery time. The thought of not being able to ride or play my guitar for 6 months with the surgery route was my deciding factor. I'm still coming to terms with the aesthetic value of it all as I'm not used to having a physical abnormality. I kinda felt that it would limit my chances of finding a girl that would find me attractive. I'm looking for a long term relationship and am over the "hooking up" phase of my life so in the end if said girl can't see past the bump then she probably isn't good for me anyways.

The silver lining that I've found is this injury was the final straw with my relationship with alcohol. I initially suffered a grade 2 from drinking and riding so even though the injury sucks it's helping me be a better version of myself in the long run. Like a lotus flower I had to suck up some shitty substance to eventually blossom. I just hope the conservative route doesn't affect my guitar playing stamina.
 
#797 ·
My questions are for those of you that went with non surgery,
How long did it take before you felt your body "normalize" to a more even balance?
Did the bump (more like a lump) go down after you recovered?
Do you worry about falling on it again?
(Could it get much worse like collar bone getting into the neck or lungs)
Those with surgery
What foods/diet worked best for recovery?
How long did the pain last from surgery?
What were risky movements post surgery that could snap ligament?
What devices are beneficial to recovering quickly and comfortably?

This is a really tough injury both mentally and physically. I was really depressed the first week and pray to the universe that can scheduled next week for an op. I going to just stay positive, proactive and hope for the best because that's all I can really do right now. I Know It Will Get Better. It can't rain forever;)
I did not have surgery. The orthopedic specialist I saw said while I was an excellent candidate for surgery, my insurance company would consider it an aggressive form of treatment and he assured me my recovery would be quicker without surgery than with. And he was confident I would make a full recovery.

I wasn't able to tie my own shoes for about a month after my grade 3 AC separation, it was pretty painful for quite a while. After that though, it seemed to improve pretty rapidly. I was able to ride again after 5 weeks with minimal discomfort although my range of motion still wasn't that great. It was probably 4-5 months before I felt pretty close to normal.

It will be 4 years since it happened in a couple weeks, other than an occasional clicking feeling when I rotate my right arm over my head windmill style, no problems. I am able to throw a baseball, football, bowl, swing a bat, lift weights, etc. Range of motion is at least as good as my other shoulder. No issues sleeping on my right side either. No worries about re injuring it, we all know that bike riding has inherent risks and when you get on a bike, you are accepting the risk of potential injury. I've taken a couple tumbles on my MTB (been a roadie for years, got a MTB right after Christmas this past year) and no problems at all.

No real lump either, you really have to look to see it. I do have more upper body size than the average cyclist though, maybe that helps hide it?
 
#799 ·
I am going on week 8 of my grade 3. Both orthos initially recommended no-surgery. Had full ROM by week 2 with good strength and really no pain with basic tasks.

Started physical therapy week 2. Focus was on building back muscles (scapula and lats) that helped get my strength back. Running and biking by week 4. Started free style swimming and doing sets of 10-15 pull ups by week 5. Weight amounts in gym increased to 50-70% of healthy shoulder depending on exercise by week 6. Resumed all "normal" activities and mostly forgot about the injury by week 7.

BTW, the PT strongly advised against doing any of these activities for "several more weeks" as I need to let the shoulder "heal" before I can rebuild it. I told her it feels good, my body likes it. What am I supposed to do, watch my chest and arms deteriorate? This will just prolong the recovery.

So I was feeling pretty good and decided to paddle out for a surf last weekend (wk 7) in 3-4 ft waves. Other than the occasional sting in the deltoid/clavicle area everything seemed fine. However, I was tight for 2 days after in the same area. I paddled out again today in bigger 4-6+ft surf that put more stress on the shoulder and I felt pulling by the clavicle when I pushed it. I have no pain but the "bump" is noticeably bigger now as I can feel more separation between the clavicle and acromion.

So, I am going back to the ortho tomorrow to do find out WTF is going on. If the grade 3 recovery period is 6-12 weeks then am I past the "healing" stage and into the "rebuilding" stage? What is their definition of "full function" at week 12? Brushing my teeth or paddling, swimming, biking, etc.? If I can't surf now then when?

I discussed with another PT and ortho I met at a party last weekend and both said I shoulder strongly consider surgery. The 2 people I know that got surgery are happy. Ones that went without are mixed.

If the ortho recommends surgery then I am doing it. I would rather bite the bullet now and get it done rather than dragging this on for months or potentially years and risk never getting back to normal.
 
#800 ·
Going in for surgery in 2 weeks. 2+ hours outpatient.

Surgery involves small incisions to harvest a healthy tendon from behind the knee and transplant it (graft) to the clavicle. No screws, plates, etc that I heard were problematic with earlier surgical techniques.

4-6 weeks in a sling w minimal ROM exercises, then PT and 4-6 months full recovery; like it never happened with the exception of 2 minor scars.

Basically, I am going back to square one and lose the 8 weeks I put in to nonsurgical recovery. Good news is I know what to expect (basically same recovery process weeks 1-8) and perceive this loss of time as a relatively small tradeoff for a much better shot at a 100% recovery.
 
#849 ·
Yes, that was exactly my situation. I started playing again after the 3rd or 4th week with an acoustic. My arm and shoulder did get tired easily, with stiffness around my neck after playing (we are talking right shoulder having the separation, and playing normal right handed guitar).

I play in a worship team, and based on healing progress, I was able to come back after 8 weeks. Might've done it sooner, but wanted to be safe. I couldn't lift the guitar over my right shoulder with my right hand ... Had to use my left. It all cleared up after 12 weeks and now back to normal.

Hope this helps
 
#802 · (Edited)
I joined the club on 4-29-15. Road biking, second in paceline when lead rider grabbed two fistfuls of brakes going UPHILL at about 18mph and skidded to an immediate stop. :(

Level III separation that was repaired yesterday (5-14-15) via arthroscopic Dog Bone procedure. I will post updates as I recover. But I can report that I was back out on the road bike 11 days after the crash and 4 days before surgery. I choose to repair immediately during acute phase because of extreme amount of displacement especially noticeable on my 5'10" 145 lbs. climbers frame.
 
#803 ·
Update: 6th day post surgery and I'm pretty much completely pain free and I've been off narcotic meds since 2 days post surgery. Riding recumbent stationary bike and watching a lot of cycling videos. Starting very basic range of motion rehab on arm of injured shoulder.
Not looking forward to long road to full recovery but even at this early stage VERY glad I opted for surgery! 100% sure I'll recover to 100% functionality of injured shoulder via this route. :)
 
#804 ·
1 week post surgery for Grade 3; less painful than original injury at same time. Not sure this is because of the 10 weeks of PT before the surgery. Pain is in muscles affected by pulling the dropped shoulder back in place (pectoral/upper bicep/deltoid area-not clavicle/acromion area with the original area). ROM is coming back quickly and hope to start PT in a week. Recovery is expected 4-6 months.

AC and CC joints repaired. There is a temporary screw that replaced the damaged end of the clavicle (was cut) holding repairs in place. Torn joints replaced with artificial tendon (new string like material that is super strong - can tow a boat) so no need to harvest a tendon from my knee.

No regrets. Shoulder is normal, no bump and square (not sagging) with my other shoulder. I am a lot more optimistic this will result in a 100% recovery than with the nonsurgical conservative method that was causing nagging pain while paddling, running, throwing, virtually every athletic thing I do.
 
#805 ·
Day six from a grade 3 , I'm a freak of nature it seems.
I already almost have full range of motion, can do self assisted push ups , yesterday and today I did the elliptical and then today decided to try my pump track, all good. I spent 20 mins pump tracking hard and only had one twang or twinge in the shoulder, unbelievable.

I have been icing 4 times daily and hitting my Infar Red sauna, along with doing anything that doesn't hurt it (much) like mowing the lawn etc.
Lucky lucky so far....

I'm considering doing a bunch of fire road climbs tomorrow on day 7 with green difficulty descents.

My guess is that I already blew this shoulder 10-15 years ago playing rugby or mtb and that why it's healing so fast?
I hope it continues on healing with no set backs, common sense and listening to my pain is key. Will update weekly or as anything occurs

Happy healing to all.
 
#806 ·
I should say that day one an 2 were hell , full of pain , I dropped the sling on day 3 and things started to improve, by day 4 I could brush my teeth, by day 5 I could spike my hair.
My gut feeling is that I'm a fluke, and that perhaps ice and sauna (infrared ) are a super great combo for healing.

Healing vibes to all
 

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#807 · (Edited)
Hi all, first off, I am not a biker, but after searching and reading all these posts, I figure I may have something to contribute and maybe someone else could help with what happened to me. I have a grade 2-3 AC tear, small bicept tendenosis and labrum tears. I did not get them from impact and I did not feel pain for at least 2 months. I am a kiteboarder and took a month long kite trip to Brazil. To say the sport is intense is an understatement. I lost 35 lbs in that one month simply from kiting.

I do not know why I did not feel pain. A picture during that time shows that I have a huge bump but I thought it was just my bone showing since I lost so much weight. About 2 months later, I wake up in pain…probably slept on it wrong, or snapped it during sleep. That hurt a bunch and of course I did the stupid thing and went on another kite trip. Did a few sessions, and I was done…too much pain.

I am 40 years old and pretty fit. I did not have surgery because of all the before mentioned comments. It is now 8 months after the injury. I have just had my 2nd round of PRP shots. Previously I have had prolotherapy, PRP, lots of PT, and 2 MRI's. The recent MRI showed zero improvement. PT started with rage of motion. Initially was unable to raise hand above head. Now, I have full range of motion and 1 week ago was able to do 4 full pushups. Nowhere near where I used to be, but it's a start. Pain is mostly gone with the exception of a few workouts. Think the AC is the best it has been in awhile and now I can feel the pain the torn labrum caused, but that too is low now. What amazes me is that most of you guys are recovered or out riding after 3-8 weeks. 3-8 weeks into it I was devastated!! Everyone does heal at different times, but that's huge. I had vey limited kiting sessions with approval of my PT this month. My shoulder was fine, but my body told me my muscles weren't developed enough to handle the stress. Will have to build to it. I do not foresee me being where I was for another few months, so overall, it looks like a full year of recovery. Anyone take this long? Maybe I should have went with surgery. Maybe its not too late. Like you all, I am very passionate about my sport and need to be 100%, not 90%.

Has anyone else developed the AC tear over time without pain? I did read about that one guy who did pull-ups afterwards. Has anyone else taken this long to heal? Even at 40 y.o., a full year seems damn excessive.

I have done 3-5 day sessions of PT for a few weeks…but am also concerned that that does not allow the muscles to rebuild. Any input?

Hope you all get back to 100%

BTW, the 2nd MRI sowed no improvement at all. So, if there is no regrowth of ligaments, why do we feel better?..and is it just as prone to injury now? Yes, the muscles stabilize the joints and rebuilding them makes them stronger, but you still have torn ligaments. Inflamation causes pain. I take Triflex and Wheat grass everyday now. Will I have to work out to this level to continue to keep my muscles from degrading in hopes to be active for the rest of my life?...we'll see.

PS..in response to my question about doing PT with pain and whether or not its beneficial, my PT found this article. It was extremely helpful and kickstarted my PT:

Ligament Injury and Healing: An Overview of Current Clinical Concepts - Journal of ProlotherapyJournal of Prolotherapy
 
#808 ·
I don't mountain bike but snowboard faithfully, got 115 days in this season before my season ending injury. This thread has been extremely helpful to me throughout the process of my Separated shoulder so I promised myself I would post here.

I had A high grade 1 separation on my right shoulder in the beginning of january snowboarding in whistler, and after about a month I was back to normal like I never even did it. On April 20th I really did my right shoulder in with a grade 3 separation snowboarding yet again. Initially I was in shock and thought I dislocated as I felt a huge bump on my shoulder, went down to the park and felt extremely nauseous, and almost fainted. Went to the doctor and gave me a sling, wore it for 3 days than got rid of it. It hurt like a ***** but not excruciating pain and only took t3s for the first 3 days at night to help sleep. During the first week I did lots of meditation to help keep myself calm and not go crazy. After week 1 I was at 50% range of motion and had a little bit of strength, couldn't lift my arm above my shoulder. 2-3 week went to PT(only time I went cause I don't have insurance, got a bunch of ROM excercises, was told to do as strength training within my pain threshold) I started on the stationary bike almost everyday to keep blood flowing, and did ROM exercises faithfully everyday. Also went to the hot tub after working out, and would Ice/ heat about 2 times a day( always after I worked out) when I got home. Week 4-6,100% ROM by now, started doing light yoga( able to do downward dog without pain) Strength training exercises (mostly with bands and light weights). Back to normal weight from before injury with bicep curls. My gf gave me acupuncture 4 times which really helped to ease the pain around back, neck, shoulder. Now I am in week 7 and am pretty much normal with everyday activities, I still can't sleep on the shoulder for more than 10 minutes without a dead/ arthritic feeling. I get the occasional twinge when I do an awkward movement and also it cracks like crazy when i'm doing random stuff. I am glad I choose the non-op route, Only thing I would've done different was if I had coverage PT at least once A week, also Osteopath does wonders (couldn't afford it at 120 an hour), massage therapy also. It has been a long tedious process but being patient and having a positive outlook makes the process way easier.

Age- 23 years old- Bump on shoulder also went down a little bit (lucky i have pretty broad shoulders so not to noticeable) very noticeable when I cross my shoulders or lay on my left side it sticks out like crazy.
Supplements- D3, Zinc, fish oil, Chondroitin and Glucosomene with MSM

I will post an update at weeks 8-12
 
#809 ·
Well, at almost 5 weeks post-op (Arthrex Dog Bone procedure) for level III separation with considerable displacement I've ditched the sling (I know, I know...wear the sling 24/7 for six weeks...but it was just not needed anymore after one month post-op...I've just restricted movement of the arm and don't reach overhead, out or too far to the side).
I'm waiting another week before I start active rehab and strengthening exercises. I probably could ride the road bike right now for shorter distances but I'm not going to push it that far.

All and all I'm completely satisfied with my decision to have surgery. In another month I'll be "good as new" and the injury will just be an unpleasant memory.
 
#810 ·
I just stumbled on this thread today, and I am so glad I did. I'm 44, drive a desk professionally, and I am an avid recreational MTBr in the spring/summer/fall, and downhill skier in the winter. I could not be more disappointed to be off my bike with a level 3 separation. I saw the Orthopedic doctors at Columbia Presbyterian, who come highly regarded in their field, and they said to give it 8 weeks of therapy and see were I stand before thinking about surgery.

I went down on June 14th. The pain was pretty intense for the first 36 hours, but I quickly transitioned of the pain killers and rested for 3 days working from home. I started PT on June 19th and am going 3x per week. So far, things are going pretty good. ROM today is much better than was expected per the PT and far ahead of what he typically sees.

As such, the PT has cleared me to drop the sling and is encouraging me to get a brace to help pull my shoulders back and push the bone down. Has anyone had an experience with these braces and can make a recommendation? He did not have one in mind, but was going to research it.....
 
#811 ·
So many Grade IIIs!! I had a grade V about 6 years ago. Last thing I remember was throwing my leg over the demo Moots I was test riding. Next thing I remember was wandering in the middle of the trail and being brought back up to the trailhead by some fellow riders, that also happened to be off-duty Colorado police officers!!

Had surgery and 6 years on have absolutely zero problems! They had to put screws in, and took those out at around 8-10 weeks if memory serves.

Rock on!!
 
#812 ·
Hey everyone! Hope everybodys shoulders are healing up well!

I have a question about my injury. I messed up a good jump at the Canyons last thursday and ended up hitting my shoulder pretty hard. The day it happened I could move my arm outwards and a little forward but would feel pain and lifting it over my head was out of the question. A few days later after icing it and applying heat occasionally I could move my arm pretty good with just a little bit of mild pain/tightness in certain spots.

would now be the time to start getting back to my daily GOLF regiment. Im not talking about hitting a ton of balls at the range but easing back into chips and pitches and in to full swings.

Is it right to think that I dont want to be too static with the shoulder?
 
#813 ·
Obviously the correct answer is you should check with your doctor. That said, my PT has been guiding me to use pain as my guide. If it hurts, DON'T do it. The thing to remember is that ligaments take a very long time to heal (6 to 18 months) and your joint will be in a weakened position until you've had time to strengthen the muscles around the joint. After ~2.5 weeks form my Level 3+ separation, the swelling has gone, bruising has cleared, and most of the pain has subsided. What I am noticing now is stability is compromised. While I think I can make a near full recovery with a pretty major lump on my shoulder, I am beginning to question if "near full" will be full enough for the active lifestyle with active, sports oriented little kids I want to resume. We'll see with the ortho says next week.....
 
#814 ·
L84Beer....dont wait...just my suggestion, but I am SERIOUSLY FRUSTRATED that no one told me 8-9 months ago, that I will not get back to a very active lifestyle withour surgery. I went to 2 dr's and a PT...they all seem tobe programmed to tell you to do it without surgery. I say, seriously consider surgery. Granted, I had a combo (AC tear, SLAP tear and Bicept tendenosis), but in my opinion, just wasted 8-9months of not being able to kiteboard!!!...and now will probably end up down for another 8-9 months if I opt for surgery...or just keep trying without the ability to do my sport. Not worth it. Good luck.
 
#815 ·
Tanre, sorry to hear your recovery has been challenging. I've been combing these posts for a few days, even going back to the beginning, and what I am seeing pretty clearly is the surgery/no surgery option is controversial.

Like you, I desperately want to get back to "normal" as quickly as possible. Today I am 25 days post injury and the pain is virtually gone, except sharp pains I get every once in a while on top of the joint while I'm trying to feed myself or talk on the phone--weird. From days 5 to 20 I would experience some pretty intense cramping in my shoulder blade, particularly when I do small motor skills like preparing guacamole, or standing holding a drink. Days 20 to 25 were a mix of cramping in the shoulder blade, or a couple of days where the whole shoulder would just get very tight, like a cramp, but around the whole shoulder.

When this happens, it feels like I need to manipulate my shoulder to realign the bones to take away the impingement. I have not figured out the magic manipulation to realign things and wish I could.

I'm willing to give this 2 months to see where I'm at on the non-surgical route, but I want to make sure I don't screw up my ski season. I feel like I could get back on the bike to do some light trail riding, but unfortunately most of the trails around here are fairly technical, so I don't want to chance it until I've seen the doctor next Wednesday.

I could accept a near full recovery, if I could ride a bike on our technical terrain, ski aggressively, and probably more concerning, throw a ball and swing a bat with my kids who are competitive baseball players and otherwise athletic kids. I've read about some success and struggles with throwing both with and without the surgery, further complicating the decision.

Trying to stay positive, and motivate to stay active and eat healthy are my biggest challenges right now.....staying active is constrained by the shoulder, eating too much is my downfall when I have setbacks like this.....
 
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