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A horizontal close-up of a woman receiving massage therapy on her leg as part of her charley horse treatment plan

Treat Your Nightly Calf Pain with Charley Horse Treatment

While many factors can contribute to a Charley Horse, it’s unclear what causes it — and it takes education to pinpoint the right Charley Horse treatment for your personal situation.

A variety of reasons may contribute, including dehydration, a lack of electrolytes, muscle fatigue, overstretching a muscle, cold weather, and certain medications. In addition to not stretching enough, exercising in high temperatures, eating too little magnesium or potassium, and having a spinal cord injury, you can also trigger a Charley Horse.

With the right treatment, you can safely relieve your back of leg cramps at night using minimally invasive approaches. First, you need to understand what’s happening in your calf muscles, and what makes up those areas of your leg.


Charley Horse Treatment: The Inside of Your Calf is Key

Calf muscles are located behind the shinbone on the back of the lower leg, which is where most Charley Horse treatment pain-management specialists and health care experts will focus on. In reality, it consists of three muscles.

As your muscles work together to help you walk, run, jump, stand on your toes, and flex your foot, calf muscles in particular contain the following arteries and veins:

  • The posterior tibial artery. This is a branch of the popliteal artery. As it runs down the leg, it supplies blood to the foot and calf muscles.
  • The peroneal artery. This is another branch of the popliteal artery. This vein provides blood to the calf muscles and foot at the back of the leg.
  • The posterior tibial vein. This vein drains blood from the calf muscles and the foot up the back of the leg.
  • The peroneal vein. This is another vein that drains blood from the calf muscles and the foot and runs up the back of the leg.

Calf muscles receive blood and nutrients from these veins, and waste products are removed from the muscles through these vessels. The calf muscles also have a number of smaller arteries and veins in addition to these main arteries and veins. Individual muscle fibers receive blood from these smaller arteries and veins. This is why your back of leg cramps at night deserve proper care and attention.


Veins, Vessels, and Capillaries

Muscles receive nutrients from blood via capillaries. An artery and vein are connected by capillaries. Since they are so small, only one blood cell can pass through them at a time. Muscle cells absorb nutrients and oxygen from the blood as it flows through the capillaries. Blood also contains waste products from muscle cells.

Concentration gradients drive the diffusion of nutrients and waste products. Different concentrations of a substance can be found between two areas in a gradient. The blood contains more nutrients and oxygen than muscle cells, so they diffuse into the cells from the blood. Muscle cells concentrate waste products more than blood cells, so they diffuse from the cells into the blood. With this visual in mind, you start getting a picture of why suffering through calf and foot cramps at night is serious business.

Capillary surface area also affects this entire process. Blood and muscle cells can diffuse nutrients and waste products more easily when capillaries have a greater surface area. In order to function properly, muscles need a lot of nutrients and oxygen. Capillaries are highly concentrated in muscles in order to cater to this demand. Among the body’s tissues, muscles have the most capillaries.

It’s why muscle cramps while sleeping shouldn’t be ignored — no matter how endurable (or not) they may be.


Zoom In on the Right Treatment for Your Suffering

Acupuncture, massage therapy, vein ablation, or IV hydration are all Charley Horse treatment options.

Massage therapy increases blood flow to the affected muscle, which helps relax the muscle and reduce pain. When not broken up by massage therapy, scar tissue and adhesions can also contribute to a Charley Horse. With a deep tissue massage, stretching can also help relax the affected muscle and reduce pain. Firm pressure breaks up scar tissue and adhesions. Myofascial massages release the fascia that surrounds your muscles with gentle pressure. This contrasts trigger point therapy. Oftentimes, a patient’s back of leg cramps at night won’t stand a chance against massage therapy.

A noninvasive treatment for varicose veins is vein ablation. After a specialist inserts a thin catheter into the affected vein, they seal the vein using either heat, radiofrequency, or chemicals. On an outpatient basis, doctors typically take an hour to fully perform this procedure.

Your Charley Horse caused by varicose veins has other solutions as well. Laser ablation has proven itself as a tried-and-true method. Laser ablation can help cure your frequent calf cramps at night. Similarly, laser ablation heats and closes affected veins. A laser ablation or radiofrequency ablation can be effective in treating varicose veins. The type of ablation that is best for you depends on the size and location of your varicose veins, as well as your preferences.

Last but not least, IV hydration does not directly eliminate a Charley Horse, but it can reduce its pain and discomfort by increasing fluid and electrolyte levels. To prevent muscle contractions, fluids can be injected into muscles and joints in order to lubricate them. Potassium and magnesium are essential electrolytes for muscle function. Muscles can contract when dehydrated or electrolyte-depleted.


How Cramps and Strains Relate to Charley Horse Treatment

The gastrocnemius and soleus muscles make up the calf muscle — and any Charley Horse treatment specialist will tell you it’s a prime location where they’ll focus on. These two muscles are commonly referred to as one large muscle with two sections because they attach to the Achilles tendon above your heel.

The plantaris is a small muscle that runs along the lower leg between the gastrocnemius and soleus. These three muscles are known as the triceps surae. However, not everyone has a plantaris muscle. Only a small proportion of people have these two large muscles.

When you stand, your calf muscle supports your foot and enables you to move your lower leg. When you walk or run, it propels you forward. Jumping, rotating your ankle, flexing your foot, and locking your knee are also possible. This is why you’ll need to seek immediate attention for your back of leg cramps at night.


Conditions and Injuries

Injuries to the calf muscles are among the most common in athletes. The risk of this type of injury increases for people who play sports that require sprinting and quick footwork. The likelihood of getting leg cramps increases as you age. Approximately three-quarters of people over the age of 50 suffer from leg cramps at some point in their lives.

Lower extremity muscles and calf and foot cramps at night are commonly affected by the following conditions:

  • Cramps in your legs. It can be very painful to experience muscle cramps and spasms in the calves. There are times of the day and nights when leg cramps occur. Several factors can cause them, including pregnancy, dehydration, some medications, and certain health conditions.
  • Strain in your muscles. Strains most commonly cause injuries to the calf. When you inadvertently stretch a muscle too far you also tear its fibers. Strenuous exercise or overuse can also cause this condition. Sports like soccer, basketball, football, and volleyball that require quick stops and starts and jumping are also prone to this injury.
  • A condition known as “compartment syndrome.” As a result of pressure building within a muscle, compartment syndrome can be a serious, life-threatening condition. Blood flow and oxygen levels are decreased due to the pressure. Strenuous exercise or trauma can result in the injury.
  • The “tennis leg.” This type of muscle strain injury affects the gastrocnemius muscle. People often refer to it as “tennis leg” because of how the muscle extends the leg and flexes the foot. However, it can happen in any sport. When tennis players “push off” suddenly into motion, their leg is placed in this position.


Non-Exercise Tips and Tricks Charley Horse Treatment

No matter what your level of activity (even lying in bed), there are ways to improve circulation in your legs so you won’t have to go in for Charley Horse treatment. These include walking, ankle pumping, knee bends, leg lifts, heel and toe raises, and ankle rotations. But there’s more, too: Calf stretching, leg stands, heel lifts, squats, using an exercise ball, compression stockings, and even yoga.

You can prevent your swelling and back of leg cramps at night by elevating those legs while you sleep. You should elevate your legs above your heart level. Pillows with wedge shapes make this easier. Elevating your legs in bed with pillows or folded blankets can also help circulation.

For better circulation, elevate your legs with a footstool or hassock if you’re sitting up. Also, an under-the-desk cycling device could be a good investment for those who sit a lot or spend a lot of time watching TV. You should shop around online for elliptical cycles from many different brands and types. Sitting and pedaling increases circulation in your legs, exercises your muscles, and burns calories.


Some Other Options

Herbs and vitamins may increase blood flow overall. Make sure you speak with a health care provider before taking any supplements for improving blood circulation. Certain medications may interact negatively with some supplements. Tackling your painful problem of muscle cramps while sleeping could take multiple angles, treatments, and options.

If you smoke, try to quit.  Make sure you stay hydrated. Maintain a balanced diet. Even try a warm bath when needed.

Acupuncture is especially used to treat Charley Horses. Acupuncture is beneficial for people who suffer from chronic back or thigh cramps at night, according to some studies. There isn’t a clear understanding of how acupuncture relieves this problem. When stimulated, acupuncture points relax muscles and reduce pain. By improving blood flow to the affected area, acupuncture therapy may also relieve inflammation and pain.

Find the treatment that’s right for you — immediately.


Wellness and Pain Can Help

A range of Charley Horse treatment options are available at Wellness and Pain. We offer conservative treatments, routine visits, and minimally invasive quick-recovery procedures. We can keep you free of problems by providing lifestyle education and home care advice to help you avoid and manage issues, quickly relieving the inhibiting lifestyle conditions when complications arise.

At Wellness and Pain, we personalize patient care plans based on each patient’s condition and unique circumstances to relieve pain, improve mobility and mental space, and improve your overall health.

A colored visualization of a gentleman experiencing a thigh cramp at night and in bed.

Your Thigh Cramp and the World of Nocturnal Leg Pain

When a thigh cramp or leg pain occurs during sleep, it can happen suddenly and painfully — which isn’t unusual with diabetes, neuropathy, and obesity. Muscle cramps can affect any part of your leg, though calf and thigh cramps are the most common.

However, other issues can also contribute to the pain and suffering.


Your Thigh Cramp and the World of Nocturnal Pain

Many adults across the United States report having ongoing nocturnal leg cramps, and especially a thigh cramp, according to studies. It causes severe insomnia and is usually impacted by recurrent, painful tightening in the calf muscles.  While a precise reason is unknown, it’s likely muscle fatigue, nerve dysfunction, and blood vessel impairment cause your back of leg cramps at night — not necessarily electrolyte imbalance.

The causes of nocturnal leg cramps include vascular disease, spinal canal stenosis, cirrhosis, hemodialysis, pregnancy, and other conditions. Doctors and institutions associate some medications with leg cramps. This list includes intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide. In addition, you can differentiate restless legs syndrome, claudication, myositis, and peripheral neuropathy from nocturnal leg cramps with a history of physical examination.

Back of thigh cramps at night are difficult to treat, as well as leg cramps (also known as “charlie horses”). There is uncertainty about the etiology, appropriate diagnostic evaluation, and the best treatment. There are many children and adults who experience nocturnal leg cramps. The prevalence of these conditions increases with age, and they are slightly more common in women. The symptoms of leg cramps are bothersome enough to prompt patients to seek medical attention 20 percent of the time.


The Symptoms

An average leg cramp lasts nine minutes and is painful and incapacitating. Recurrences and residual pain may follow the acute episode for hours. Secondary insomnia is typically associated with leg cramps that occur at night. It is most common to experience cramps in the posterior calf muscles, but thigh or foot cramps are also common. There are several types of leg cramps, including spasms, tightening, twinges, strains, tetany, swellings, or seizures. It is possible for cramps to be isometric or to cause limb movements, for example, extreme plantar flexion of the foot.

In spite of this, leg cramps offer family physicians an opportunity to diagnose and treat conditions such as venous insufficiency, peripheral vascular disease, and peripheral neuropathy. The difference between restless legs syndrome, leg cramps, and your thigh cramp can be difficult to distinguish, which is why the best treatment for leg cramps at night starts with a simple appointment with a pain management specialist.


The Science Behind Venous Insufficiency and Cramping

Blood returns to the heart through deep and superficial veins in your lower extremities, which is key to understanding the bodily science surrounding your thigh cramp. Several valves within the veins are responsible for maintaining normal venous flow patterns.

An obstruction in a vein (such as chronic thrombosis) or an incompetent valve can cause venous insufficiency. The valves in your body help blood flow in the right direction (towards your heart). It becomes impossible for a valve to close properly if it becomes damaged. Flowing upward toward the heart becomes difficult as gravity takes over. As a result, it flows backward, a condition known as venous reflux.

It’s possible to develop varicose veins when the venous valves in superficial veins become incompetent. Pain, swelling, skin changes and eventual tissue breakdown may result from chronic venous insufficiency in the deep or superficial venous system. Your back of leg cramps at night can become a common occurrence each time you lay down to sleep.

Pain management specialists can detect obstructions in the deep and superficial veins through special scanning. Specialists can also use ultrasound to determine the direction of blood flow in each segment of the evaluated veins. Often, they perform the evaluation while you’re upright. This tests the function of each valve as well.

It’s usually not necessary to evaluate the function of the lower extremity veins. However, it’s important to obtain a complete lower-extremity venous duplex scan when considering surgical treatment, sclerotherapy, or saphenous venous ablation. Both lower extremities may be included during a comprehensive check-up to explore why you’re suffering from bad calf cramps at night.


Contributing Factors: Valve Damage and Your Thigh Cramp

Valves in your leg veins can be damaged for many reasons, including blood clots, varicose veins, pregnancy, injury, and various medical conditions — bringing on a severe thigh cramp as you sleep.

Deep vein thrombosis (DVT) causes damage to the vein’s valves when blood clots form. Varicose veins also don’t help, as you may develop venous insufficiency due to these twisted, enlarged veins. Even a leg injury can damage your vein’s valves.

What’s more concerning: A pregnant woman’s veins may suffer damage due to the extra pressure during pregnancy. Her bad leg cramps at night during pregnancy are usually directly attributable to the extra weight and pressure.

Congestive heart failure could also be a common factor in your back of leg cramps at night. It happens when the heart does not pump enough blood to meet the body’s needs. Fluid can build up in the tissues, including the legs and feet, causing edema. Venous insufficiency can be caused by congestive heart failure in two ways: Increased pressure in the veins and reduced blood flow to the legs. Most patients are also suffering from venous insufficiency.


Other Medical Conditions

High blood pressure caused by chronic kidney disease can also damage your veins’ valves, causing chronic kidney disease. Blood becomes anemic when it lacks enough red blood cells to carry oxygen to tissues. Changes in blood chemistry can also cause chronic kidney disease, causing veins to become more vulnerable.

Your life can also get super complicated when you have diabetes. In addition to damaging blood vessels, high blood sugar can also damage veins. Veins can become weaker and have a harder time pumping blood back to the heart as a result. As a result of diabetes, you can also develop neuropathy, which damages your nerves and affects your control of leg muscles, causing them to weaken as a result. Peripheral artery disease, which results in the narrowing or blocking of arteries, is also associated with diabetes.

Obesity can also complicate diabetes. When you’re obese, the extra weight exerts pressure on your leg’s veins. This makes it more difficult for the heart to circulate blood fully. All these problems have directed many patients to find the best treatment for leg cramps at night.


Understanding the Internal Anatomy of Your Thigh

There are four main blood vessels in your thigh that you should consider when suffering from a thigh cramp: the femoral artery, femoral vein, popliteal artery, and popliteal vein. Thigh and lower leg blood flow is supplied by the femoral artery. Upon entering the thigh, it exits behind the knee at the popliteal fossa.

Located along the femoral artery, the femoral vein drains blood from the thigh and lower leg into the abdomen via the inguinal ligament. In addition, the popliteal artery provides blood to the knee joint and lower leg. Behind the knee, it enters the popliteal fossa and exits at the calf.

We can’t forget the popliteal vein. Blood is drained from the knee joint and lower leg through this continuation of the femoral vein. Located at the head of the popliteal artery, it terminates at the calf where it enters the popliteal fossa.

Smaller blood vessels in the thigh also supply muscles and other tissues with blood. Combined, all these vessels supply blood and nutrients to muscles and tissue as well as remove waste products. Your back of leg cramps at night are all connected to this highly complex and unique area of the body.


Thigh Cramp Symptoms, Questions, and Best Treatment

As you endure your thigh cramp nearly every night in bed, you may feel dull aching, heaviness, or cramping in both your thighs and legs. Too much time spent on your legs will cause them to swell up. You may experience itching or tingling in your legs. If you stand, your pain will be worse, and if you raise your legs, it will be better.

Symptoms stemming from back of leg cramps at night are no fun. Looking past your thighs, there may be redness in your legs and ankles. Around your ankles, you may notice changes in the color of your skin. Varicose veins may be visible on the surface of your legs. Skin on your legs and ankles may thicken and harden.


Some Options

How can you treat venous insufficiency? Compression stockings will help you reduce swelling in your legs, according to your pain management specialist. Sitting or standing for long periods of time is probably not a good idea. The blood in your veins will return to your heart even if you move your legs slightly.

In the same way, walking helps. Varicose veins may require surgery or other treatments if you have tried everything and still have leg pain, skin ulcers, or sores caused by poor blood flow. Anticoagulant or blood-thinning medicines may be prescribed by your doctor if blood clots are causing you problems.

When lying down, your pain management specialist may also suggest elevating your legs above your heart. Exercise can also improve your circulation, and swelling and venous insufficiency can be treated with weight loss as well.

Insufficiency of the vessels can cause bad calf cramps at night. The good news is, there is a cure. In addition to vein ablation, massage therapy, acupuncture therapy, or intravenous hydration, the best treatment for leg cramps at night starts with treating the underlying vessel disease. This will prevent cramps and aching legs from happening.


Wellness and Pain Can Help

A range of options for treating a thigh cramp are available at Wellness and Pain. We offer conservative treatments, routine visits, and minimally invasive quick-recovery procedures. We can keep you free of problems by providing lifestyle education and home care advice to help you avoid and manage issues, quickly relieving the inhibiting lifestyle conditions when complications arise.

At Wellness and Pain, we personalize patient care plans based on each patient’s condition and unique circumstances to relieve pain, improve mobility and mental space, and improve your overall health.

Charlie horses causing a woman to sit mid-run and massage her calf and lower leg in the street.

Charlie Horses

Charlie Horses: Risks, Prevention, and the Right Treatment

Charlie Horses is a common name for muscle spasms, where they can feel like your muscles have tightened up and locked down from involuntary contractions.

Even lying down or sleeping can trigger back of leg cramps at night. It’s painful and can happen suddenly. Calves and quadriceps are the most commonly affected muscles by these types of intense leg cramps, although they can occur in any muscle. In addition to the feet, arms, and abdomen, they can also occur in the hands.

It’s not clear what causes a Charlie Horse, but several factors can contribute to them, including dehydration, a lack of electrolytes (including potassium and magnesium), muscle fatigue, stretching a muscle too far, cold weather, taking certain medications (such as diuretics), and some medical conditions (diabetes, kidney disease, etc.). You can also trigger a Charlie Horse by not stretching enough, exercising in high temperatures, not getting enough magnesium or potassium in your diet, and having a spinal cord injury.

One fact is for sure: The best treatment for leg cramps at night is in reach.


Your Risks, Health, and Relationship to Charlie Horses

A pain management specialist or doctor is not needed unless you have Charlie Horses with weakness, numbness, vomiting, diarrhea, or severe sweating (which can cause dehydration). Physical exams and questions about your medical history will be done by your pain management specialist or doctor.

Those with diabetes or thyroid, liver, or nerve disorders tend to suffer from Charlie Horse activity more frequently, as do older adults, athletes, pregnant women, overweight or obese people. There are also several medical and health risk factors leading to back of leg cramps at night, according to a study at the National Library of Medicine, published in 2021:

  • Being diabetic.Type 1 diabetics experience muscle cramps around 60 percent of the time. About 80 percent of people with Type 2 diabetes have this condition.
  • Chronic renal failure.Muscle cramps in the legs are especially common in individuals with chronic renal failure.
  • Amyotrophic Lateral Sclerosis (ALS).There is a 95 percent chance that people with ALS will experience muscle cramps.
  • Having a baby.Pregnant women are more likely to experience muscle cramps at night, especially if they are pregnant.
  • Over 60 years old.Over 60 percent of Americans suffer from nocturnal leg cramps.

Nonetheless, there’s a smart way to treat your bad calf cramps at night.


Treatment and Prevention: The Best Paths Forward

Areas on your lower extremity that are impacted by Charlie Horses can benefit from simple stretching. Put your weight on the affected leg and bend your knee slightly if you have a Charlie Horse in your calf or back of your thigh (hamstring). Put your foot up against your head while seated or lying down.

Hold onto a chair and bend the knee of the affected leg if you have a cramp in the front of your thigh (quadriceps). Pull your foot upwards toward your buttocks. When you lie down, lift your foot, bend your ankle, and point your toes toward your shin to get relief. It loosens the tightness by causing the injured muscles to move in the opposite direction of the contracted muscles.

The muscles can also be relaxed with a massage, epsom salt bath, or heating pad. Ice packs or over-the-counter medications such as ibuprofen or naproxen may also be helpful.

Try relaxing your foot muscle when it tightens up to treat foot cramps. Additionally, ibuprofen can be taken over-the-counter to ease any remaining pain.

In most cases, muscle spasms resolve themselves on their own. Heat applied to your cramp — especially back of thigh cramps at night — can help ease the pain, as well as ice after the heat.

The best treatment for a Charlie Horse, however, is prevention. By drinking plenty of water, stretching before and after exercise, and avoiding cramps at night, you can prevent them. Wear comfortable, supportive shoes, eat magnesium, potassium, and calcium-rich foods, and adjust your exercises as needed. See what the American Academy of Orthopedic Surgeons recommends for calf stretches, hamstring stretches, and quadriceps stretches.


Additional Cures for Charlie Horses and Night Cramps

Those suffering from Charlie Horses can also benefit from vein ablation, massage therapy, acupuncture, or IV hydration.

Using vein ablation, varicose veins can be treated in a non-invasive manner. Heat, radiofrequency, or chemicals are used to close the vein after a thin catheter is inserted into it. About an hour is usually required for the procedure to be performed outpatient.

A vein can be ablated using laser or radiofrequency energy, helping cure back of leg cramps at night. Laser ablation uses a laser to heat the vein, causing it to close. Varicose veins can be effectively treated with laser ablation and radiofrequency ablation. It depends on the size and location of your varicose veins, as well as your preferences, as to what type of ablation is best for you.

The benefits of massage therapy include the increase in blood flow to the affected muscle, which helps to relax the muscle and reduce pain. Scar tissue and adhesions can also contribute to a Charlie Horse when they are not broken up by massage therapy. Stretching the affected muscle can also help relax it and reduce pain with a deep tissue massage. Firm pressure is used to break up scar tissue and adhesions. In contrast to trigger point massage, myofascial release massage uses gentle pressure to release tension in the fascia, which surrounds your muscles.


Acupuncture Therapy and IV Hydration

A Charlie Horse can also be treated with acupuncture therapy. According to some studies, acupuncture reduces the frequency and severity of a Charlie Horse in people with chronic bad calf cramps at night. It’s not fully known how acupuncture relieves the problem. Acupuncture points have been found to relax muscles and reduce pain when stimulated. Inflammation and pain may also be relieved by acupuncture therapy by improving blood flow to the affected area.

Lastly, IV hydration does not directly eliminate a Charlie Horse, but it can reduce its pain and discomfort by increasing fluid and electrolyte levels. Muscle contractions can be prevented by fluids lubricating the muscles and joints. A muscle’s function relies on electrolytes like potassium and magnesium. In dehydration or electrolyte depletion, muscles can contract.


Origin and Meaning: Describing Leg Cramps

A Charlie Horse — and the plural “Charlie Horses” — is believed to have originated in the United States in the late 1800s, although its origin is unclear. Several theories exist about the origin of the term. It’s believed that the term originated from the name of a baseball player named Charley Radbourne.

In the 1880s, Radbourne pitched for the Boston Beaneaters. During games, he was known to get daytime leg cramps, which can lead to back of leg cramps at night. Newspaper reporters used the term “Charlie Horse” to describe Radbourne’s leg cramp one day.

It may also be derived from the name of a horse that pulled groundskeepers’ carts in baseball parks. It was common for these horses to get leg cramps from being overworked and tired. In reference to the horses, these cramps became known as a “Charlie Horse.”

The term may have been derived from a horsefly that bites horses, according to another theory. As a result of their ability to cause leg cramps in horses, a horsefly of this sort is called a “Charlie Horse.”

It’s now common to refer to back of thigh cramps at night as a “Charlie Horse,” no matter what the origins of the term are. As well as in informal settings, it’s used in medical settings as well. A leg cramp can also be called a muscle cramp, a muscle spasm, a calf cramp, a shin splint, a night cramp, and a writer’s cramp.


Wellness and Pain Can Help

A range of options for treating Charlie Horses are available at Wellness and Pain. We offer conservative treatments, routine visits, and minimally invasive quick-recovery procedures. We can keep you free of problems by providing lifestyle education and home care advice to help you avoid and manage issues, quickly relieving the inhibiting lifestyle conditions when complications arise.

At Wellness and Pain, we personalize patient care plans based on each patient’s condition and unique circumstances to relieve pain, improve mobility and mental space, and improve your overall health.

Keep reading to learn more of what what you can do about leg cramps and charley horses.

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