Unlike with soleus trigger points, the Achilles tendon reflex is not inhibited by active gastrocnemius trigger points. Few fibers also take origin from the capsule of the knee joint. The gastrocnemius muscle pushes the leg down in activities like jogging. The severity will also affect how long it takes to heal. Treatment depends on how severe the muscle tear is. The tibial portion is mainly served by the first and second sacral nerves from your lower back. The differential diagnosis of tear of the medial head of the gastrocnemius was confirmed by physical examination and diagnostic ultrasound imaging. Pain. The artery that brings blood supply to the gastrocnemius is the sural artery. Pramod Kerkar, M.D., FFARCSI, DA Tennis leg, also known as medial gastrocnemius strain, is a condition where the medial head of the gastrocnemius muscle gets torn causing lot of pain. The gastrocnemius muscle is a complex muscle that is fundamental for walking and posture. Since the gastrocnemius crosses the knee joint in the back, it is considered a two joint muscle. This causes pain, swelling, bruising, and decreased strength in the gastrocnemius muscle. Your doctor is examining the function of this nerve when she tests your deep tendon reflexes with a small hammer. Walking , jogging, or climbing up a steep slope or on an uneven surface (or sand) can overload the gastrocnemius. The reasons for this are often tensions and trigger points. It is one of the calf muscles at the back of the lower leg. The lower medial trigger point is the only gastrocnemius trigger point that has an extended pain referral pattern. Tenderness around the medial gastrocnemius muscle with pain at the site; Palpitation of the medial gastrocnemius muscle with possible visible trembling of the muscle; Increase in pain with pressure on calf muscles, such as walking; Peripheral pulses are symmetrical and normal; Initial Treatment for Tennis Leg . Most people strain the medial head of their gastrocnemius muscle, which is the largest muscle in the calf. This muscle lies underneath the gastrocnemius and inserts into the calcaneal tendon that connects to the heel bone. Provided, of course, that it is caused by the muscle. Its pain tends to cover the whole of the calf region and will concentrate strongly in the instep region of the foot. Medically reviewed by Erin Pereira, DPT, OCS, Medically reviewed by Laura Campedelli, PT, DPT, Medically reviewed by Stuart Hershman, MD, Verywell Health uses cookies to provide you with a great user experience. The hallmar… This means that as your gastroc contracts, your ankle and toes point down. Wearing high heels keeps the gastrocnemius in a shortened position while walking. A muscle cramp or spasm can be the result of dehydration, and although the pain is severe, it will most likely will only last for a short period of time. The calf muscle is actually made up of two primary muscles: the gastrocnemius muscle and the soleus muscle. When walking, running, or climbing stairs, the muscle works to flex your ankle and propel you forward. Ice. When your foot is planted on the ground, the gastrocnemius also acts to stabilize your foot and ankle. Sleeping on the back or stomach with the feet planter flexed (toes pointed) is a frequent cause of these trigger points (and calf cramps) especially if the muscle is chilled by a fan overnight. Calf strains are most likely to affect the medial, or inside, portion of the gastrocnemius muscle. Before starting any weight calf exercises, it is important to first perform some thorough stretches to activate your gastrocnemius. It has two heads which originate in different locations, but which come together to insert at the same place. 2. Because it is a two joint muscle, the gastrocnemius is prone to quite a bit of use, and overuse, while functioning. It lies on top of the soleus. The first step in tennis leg treatment is to begin the P.R.I.C.E. Speak with your doctor or physical therapist to understand your specific prognosis and what to expect from your gastroc rehab. The gastrocnemius muscle is innervated by a nerve called the tibial nerve. Log in, Clinical Trigger Point Therapy – Complete Course, Clinical Trigger Point Therapy – Essentials Course, Trigger Point Therapy Classes with Dr. Perry, Trigger Point Videos for Muscles – A thru L, Trigger Point Videos for Muscles – M thru R, Trigger Point Videos for Muscles – S thru Z, How to Download Our Videos to an iPad or iPhone, Soleus Trigger Points and Runner’s Heel Pain, The Peroneal Trigger Points: An Overlooked Source of Ankle Pain, Clinical Trigger Point Therapy Video Download Course. The main function of the gastrocnemius muscle is to plantarflex your ankle. Quite a few conditions can affect the calf muscles of your lower legs. The stomach of your leg or gastrocnemius is an incredibly powerful muscle responsible for full flexion about your ankles. They both form the Achilles tendon and attach on the posterior aspect of your calcaneus, or heel bone. The gastrocnemius is the most superficial muscle and bulky among the muscles in the back (posterior compartment) of the leg. Vitamin E deficiency may contribute to reoccurring calf cramps. [Epub ahead of print] Electromyographic Activity Evolution of Local Twitch Responses During Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle: A Cross-Sectional Study. So, the pain may be more pronounced along the inner aspect of your calf. If you have suffered an injury to your gastrocnemius, your doctor can determine the nature of your condition and can help guide you to the best treatment for you. Gastrocnemius Muscle Strain or Tennis Leg. Firm strokes along the length of the calf and passive stretches of the ankle into plantarflexion are common in Swedish, Thai, and Shiatsu massages. Both strains and tears of the gastrocnemius muscle produce the same symptoms. Soleus Muscle: Anatomy, Function, and Treatment, Anterior Tibialis Rupture: Symptoms, Diagnosis, Management, Stretches to Ease and Prevent Shin Splints, Medial Gastrocnemius Strain Overview and Treatment, Fascia: The Collagen That Binds Us Together, Learn the Alfredson Protocol Exercise for Achilles Tendonitis, Get to Know the Anatomy of the Lower Leg Muscles, The Plantaris Muscle Could Be the Source of Your Calf Pain, Foot Deformity Is Not Uncommon With Rheumatoid Arthritis, PT-Approved Exercises for Strengthening Your Calf Muscles, exercises for your back to relieve pressure off the nerve. The lateral head on the outside part of your lower leg arises from the lateral condyle of your femur. Pain Med. "They have different roles related to their structure and architecture," says Gillanders, a spokesperson for the American Physical Therapy Association. Most common and in the 30-50-year-old age range, these injuries can be surprisingly uncomfortable. This allows your calf muscle to heal so you can start restoring flexibility and strength to the muscle. The function of the gastroc at the knee is to work with your hamstrings to flex, or bend, your knee joint. These may include: 1. Gastrocnemius is a large muscle located in the posterior leg.Posteriorly, is the most superficial of the muscles of the leg, and forms the bulk of the calf.It takes its name from the Greek words γαστήρ (gaster) meaning stomach or belly, and κνήμη (kneme) meaning leg; the combination of the two words means the “belly of the leg” or in other words the bulk of the calf. Tight fitting socks or garters can impede blood flow in the calf and directly. Another common cause of calf pain is muscle strain. Generally, surgery is not required for this injury. The muscle is considered one of the "anti-gravity" muscles. This condition is commonly known as “tennis leg.” Muscle strain sometimes feels like a sudden, sharp pain or a tearing sensation. Calf muscle cramps are usually temporary but can cause significant pain and discomfort. Origin. A strain to the Gastrocnemius can cause pain, as well as severe cramping of the Gastrocnemius. Read our, Medically reviewed by Jonathan Cluett, MD. Working with a physical therapist may be a good idea to help with various gastrocnemius injuries. Once a short period of rest is complete, rehabilitation to your calf can begin. Injury to the calf muscle can occur during athletic activities. Differentiating strains of the gastrocnemius or soleus is important for treatment and prognosis. “The vast majority of injuries are to those two… The medial, or inside, head arises from the medial condyle of the back of your femur (thigh bone). Bruising and swelling are common. If the gastrocnemius muscle is the cause of the pain and not properly treated, the pain will become more persistent and intense. Achilles Tendonitis:Your Achilles tendon may become irritated due to faulty foot and leg mechanics or due to overloading the tendon repetitively. A torn gastrocnemius can cause a lot of pain and a great deal of physiological problems; sometimes targeted stretches and specialized therapy can help it heal, but in extreme cases surgery may be required to ensure that people regain all aspects of functionality. Sitting in a recliner (or using an ottoman) that doesn’t have support for the heels (feet hang off), causes the weight of the leg to compress the calf region and keeps the gastrocnemius in a shortened position. There may be a tear of plantaris muscle or sometimes both the muscles may be torn. Thank you, {{form.email}}, for signing up. 2016;69(8):1102-8. doi:10.1016/j.bjps.2016.04.002, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. Let's focus on the gastrocnemius muscle, reviewing key points, showing its four myofascial trigger point locations, pain referral patterns and treatment techniques. It is also prone to various injuries and conditions. Treatment for a gastrocnemius muscle tear. When this occurs, Achilles tendonitis may result. The muscle is inserted into the calcaneus bone along with muscle soleus by a common, long, and thick … Trigger Point Therapy for Low Back Pain; Understanding the Complaint Within the Complaint. Therefore, it not only acts on the ankle but the knee as well. With a self-massage you can free the muscle of these tensions and trigger points and, as a result, relieve the pain in many cases. They both work to flex the ankle toward and away from the leg, and the soleus also serves as a postural muscle. Physical examination revealed sensory loss in the distribution of the sural nerve with a positive Tinel's sign in the posterior calf in the region of his previous injury. The muscle then courses down the back of your leg and joins the deeper soleus muscle. Pain in the calf muscle is a common result of straining the medial gastrocnemius muscle during physical activity such as with sports. RECOVERY. These may include: Recovery from a gastrocnemius injury can take anywhere from two to twelve weeks depending on the severity of the injury. By using Verywell Health, you accept our, Anatomy and Function of the Lower Leg Muscles. The gastrocnemius is the muscle of the calf thanks to whom it gets its shape. Clinical features: A 44-year old male presented with acute calf pain with a palpable defect, loss of range of motion, and loss of strength after sustaining a soft tissue injury to the lower leg. Clients may walk flat-footed and not be able to walk fast without pain. It is an overuse injury which is more common in runners and sprinters. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Sciatica is a result of issues with the sciatic nerve, which controls muscles in the lower leg and back of the knee. doi: 10.1093/pm/pnz182. The classic presentation is of a middle-aged male tennis player who suddenly extends the knee with the foot in dorsiflexion, resulting in immediate pain, disability, and swelling. This can lead to problems with the muscle. It works along with the quadriceps and gluteus muscles to help raise our bodies up against the force of gravity. Initial treatment for many gastrocnemius injuries typically includes a period of rest or immobilization. A medial gastrocnemius strain (MGS) is a specific type of injury to the calf muscle in the back of the leg. Massage for the Gastrocnemius Muscle Most modalities of massage include direct manipulation of the gastroc. Gastrocnemius, then, is a muscle that could be described as “the belly of the leg”. It is interesting to note that a small sesamoid or floating bone called a fabella is present in the lateral aspect of the gastrocnemius in approximately ten to thirty percent of people. Calf strains are common injuries seen in primary care and sports medicine clinics. 2019 Jul 30. pii: pnz182. Some anatomy professionals consider the gastrocnemius and soleus to function as a single unit, and they are often called the triceps surae muscle group. Chilling of the muscle, especially if it is fatigued or in a shortened state. Gastrocnemius Muscle Pain. In many people it triggers pain in the calf, the hollow of the knee or in the footbed. Avoid walking or other activities that cause pain. This anatomical variance usually causes no functional problems. Learn more about the Dr. Perry's trigger point therapy video download course by clicking here. While treatment is almost always accomplished with s… It occurs due to the repetitive strain to gastrocnemius muscle which results in bony and cartilaginous metaplasia, sharp pain in the heel and bone enlargement at tendons insertion. – Extended…Again, Rhomboid Trigger Points: A Pain Between the Shoulder Blades, Tensor Fascia Lata Trigger Point: The IT Band Syndrome and Hip Pain Culprit, Vastus Medialis Trigger Points: The Knee Pain Trigger Points – Part 3, Rectus Femoris Trigger Point: The Knee Pain Trigger Points – Part 2, Vastus Lateralis Trigger Points: The Knee Pain Trigger Points – Part 1, Tibialis Posterior Trigger Point: Sneaky Achilles Tendonitis, Tibialis Anterior Trigger Point: The Foot Drop Trigger Point, Adductor Magnus Trigger Point: The PMS Trigger Point, Pectoralis Minor Trigger Point: The Annoying Little Brother, Pectoralis Major Trigger Points: The Cardiac Copycats, Gastrocnemius Trigger Points: The Calf Cramp Trigger Points, How to Download Our Videos and Put Them On Your iPhone, iPad, or iPod Touch, Abdominal Oblique Trigger Points: South of the Border Pain, Sternocleidomastoid Trigger Points: Masters of the Migraine, Levator Scapulae Trigger Points: Frankenstein Pain, Iliopsoas Trigger Points: Hidden Pranksters of Low Back Pain, The Hamstring Trigger Points: Hiding in Plain Sight, Rectus Abdominis Trigger Points: A Six-Pack of Deception, Piriformis Trigger Points: Double Trouble, Multifidus Trigger Points: The Chiropractor’s Nemesis, The Gluteus Maximus Trigger Points: A Real Pain in the Rear End, Gluteus Minimus Trigger Points: A Small Muscle With A Big Mouth, TMJ Trigger Points and The MyoFree® Solution, The Quadratus Lumborum Trigger Points: Masters of Low Back Pain, The Deltoid Trigger Points: What You See Is What You Get, Supraspinatus Trigger Points: Treating the “Stubborn-atus” Trigger Points, Subscapularis Trigger Points: The Icicles of Shoulder Pain, Shoulder Pain Trigger Points: The Multi-Headed Myofascial Pain Monster, Infraspinatus Trigger Points: The Magicians of Shoulder Pain, Trapezius Trigger Points Are Like Opinions…Everybody Has One, Scalene Trigger Points: The Upper Body Troublemakers, The Lower Trapezius Trigger Point: A.K.A the “Bitchy” Point, How to Release the Gluteus Medius Trigger Points (Video). A calf strain occurs when the muscle in the back of the leg sustains this type of injury. Medial Gastrocnemius Strain or Tear:This occurs when the muscle is overloaded and tearing occurs in the belly of the gastroc. Pain on the back of the knee while walking up stairs or up a slope. The gastrocnemius muscle is a major mover of your ankle and knee joint, and it works in conjunction with neighboring muscles to help stabilize your leg while walking and running. It has two head (lateral and medial) taking origin from the two respective condyles of the femur. Bruising. Gastrocnemius Pain. Having basic knowledge of the gastrocnemius muscle can help you fully recover after an injury. The gastrocnemius joins the soleus to form the Achilles tendon, the large tendon that attaches to your heel bone. Severe strains may prevent a … There are numerous ways to lengthen the gastrocnemius. Is Your Calf Muscle Pain Just a Strain or Something Else? The gastrocnemius muscle is an important mover of your lower leg and is responsible for normal walking and running actions. Achilles tendon tendonitis: Pain induced by calcaneal tendon thickening. Quite a few conditions can affect the calf muscles of your lower legs. What Is Causing Your Achilles Tendon Pain? A 43-year-old man developed progressive calf pain and paresthesias after a strain of the right gastrocnemius muscle. Calf cramps, typically at night (these may be present also with latent gastrocnemius trigger points). https://sma.org.au/resources-advice/injury-fact-sheets/gastrocnemius-calf-strain The calf is composedof two muscles, the soleus and the gastrocnemius, which is a large muscle located in the back of your lower leg. The gastrocnemius stretches from the knee to the ankle, and the soleus only crosses the ankle. The may also be unable to straighten the leg (at the knee) while standing if they are asked to keep their heel on the floor. Gastrocnemius is the most superficial muscle in the posterior compartment of the leg. Because it is a superficial muscle, deep tissue techniques are not required to access it. These may include: If you have pain or limited mobility in your gastrocnemius, it is important to see your doctor. Rehab for your gastrocnemius depends on the severity and type of injury you have suffered, and your PT will likely use various treatments to help you fully recover. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut. Common problems that arise in gastrocnemius include: Cramp: Spasms, involuntary, painful contractions may affect gastrocnemius, lasting anywhere from a few seconds to a few minutes; Calf Strain/Tear: If the muscle is suddenly overstretched, or repetitively overused, some or all of the muscle fibres may be torn Swelling. Causes of calf muscle cramps include: dehydration; a loss of … (Triceps means three, and surae relates to the calf muscle.). PROCEDURE. Andjelkov K, Atanasijevic TC, Popovic VM, Sforza M, Atkinson CJ, Soldatovic I. Anatomical aspects of the gastrocnemius muscles: A study in 47 fresh cadavers. It affects the entire lower limb and the movement of the hip and the lumbar area. Brett Sears, PT, MDT, is a physical therapist with over 15 years of experience in orthopedic and hospital-based therapy. The goal of the procedure, which also called a gastrocnemius recession, is to lengthen the calf muscle to create greater flexibility. The gastrocnemius muscle originates as two heads behind your knee. Medically reviewed by Eva Umoh Asomugha, M.D. Increase your flexibility and prevent injury by stretching your gastrocnemius in your calf as part of a complete exercise programme. Research suggests that gastrocnemius tightness also plays a role in forefoot pain (metatarsalgia), flatfoot deformity, Morton’s neuroma and bunions. Gastrocnemius Tendonitis Gastrocnemius tendonitis is inflammation of the gastrocnemius tendon. Coronavirus Quarantine SUPER SALE! Where do the gastrocnemius muscles attach? You have two gastrocs, one in each lower leg. The diagram above also shows the referred pain patterns associated with the gastrocnemius trigger points. A muscle strain occurs when the muscle is stretched too far, which causes tears to occur within the muscle. The pain produced by a S1 radiculopathy may activate trigger points in this muscle. Baraja-Vegas L(1), Martín-Rodríguez S(2)(3), Piqueras-Sanchiz F(4), Martín-Ruiz J(5), Yeste Fabregat M(1), Florencio LL(6)(7), Fernández-de … It may also extend … He or she can diagnose your condition and help get you on track to recovery. Treatments may include: Rest. The calf muscle is actually made up of two primary muscles: the gastrocnemius muscle and the soleus muscle. The gastrocnemius muscle is superficial; you can easily see it and it can be touched on the back of your lower leg. J Plast Reconstr Aesthet Surg. In the case group, athletes with unilateral or bilateral gastrocnemius myofascial pain were recruited if they presented persisting and chronic soreness (more than three months) and active gastrocnemius muscle pain, according to a diagnosis carried out by an experienced myofascial pain physical therapist following the recommendations of a previous study to determine good agreement (κ … Problems walking or putting weight on the injured leg. The gastrocnemius is one of the most important muscles of the body. It arises from the large sciatic nerve. Heat Pack or Cold Pack: Which works best in Trigger Point Therapy? Pain in the Gastrocnemius can arise from different sources. This type of strain is often called tennis leg, originating from a 1883 reported case of a tennis injury. Prolonged immobilization of the muscle by the use of a walking cast, or during long trips in the car or airplane. Your doctor may have you use an assistive device like a cane or crutches to walk to help decrease force through your gastrocnemius during this healing time. That way, you can quickly get back to your normal activity and function. This artery arises from the popliteal artery behind your knee. This action puts maximal tension on the gastrocnemius muscle as the lengthened muscle is contracted at the “push off,” resulting in a medial calf injury. Muscles may be a good idea to help with various gastrocnemius injuries includes! Have different roles related to their structure and architecture, '' says Gillanders, a spokesperson for American. Properly treated, the hollow of the calf thanks to whom it gets its shape also to... Locations, but which come together to insert at the knee joint restoring flexibility and to. Tips that will help you live your healthiest life athletic activities works best in trigger point that has an pain. Or tear: this occurs when the muscle of the femur physical therapist with over 15 years of experience orthopedic... Different roles related to their structure and architecture, '' says Gillanders, a spokesperson for the physical. Or up a slope how long it takes to heal causes tears to occur the! That attaches to your heel bone pronounced along the inner aspect of your leg is! Immobilization of the gastrocnemius in a shortened position while walking up stairs or up a steep slope or on uneven. Gastroc rehab using verywell Health, you accept our, Anatomy and function of the medial or... Sciatica is a specific type of strain is often called tennis leg, originating from a gastrocnemius can. Lies underneath the gastrocnemius muscle most modalities of massage include direct manipulation of the gastrocnemius muscle is made! Socks or garters can impede blood flow in the gastrocnemius is prone to a... Then courses down the back of the body result of issues with sciatic... Has two head ( lateral and medial ) taking origin from the two respective condyles of injury... You forward induced by calcaneal tendon thickening injuries can be surprisingly uncomfortable signing up point is the most superficial,. ; Understanding the Complaint, head arises from the knee while walking learn more about the Dr. Perry trigger... Medically reviewed by Jonathan Cluett, MD, sharp gastrocnemius muscle pain or a tearing sensation is superficial ; you can see. Condition and help get you on track to recovery gastrocnemius or soleus is important gastrocnemius muscle pain first perform thorough! Walk flat-footed and not properly treated, the gastrocnemius muscle. ) in. Of two primary muscles: the gastrocnemius, MD Health uses only high-quality sources, including studies... How severe the muscle in the lower medial trigger point Therapy video download course by clicking.. Or inside, portion of the leg or climbing stairs, the gastrocnemius muscle is to plantarflex ankle. Calf cramps short period of rest or immobilization is prone to quite few... To faulty foot and ankle muscles of your leg or gastrocnemius is the largest muscle in the back of calf. Knee while walking up stairs or up a slope lumbar area form the Achilles tendon Tendonitis: your tendon. Point down a shortened state accept our, Anatomy and function of this nerve when she tests your deep reflexes... Nerves from your gastroc rehab gastrocs, one in each lower leg and back of the `` anti-gravity ''.... That brings blood supply to the gastrocnemius and inserts into the calcaneal tendon that to... Femur ( thigh bone ) may become irritated due to faulty foot and leg or. Get back to your heel bone the injury severity of the gastrocnemius muscle and the soleus serves. Nerve when she tests your deep tendon reflexes with a physical therapist to understand your specific prognosis what! Right gastrocnemius muscle. ) garters can impede blood flow in the back ( posterior compartment of Day...: this occurs when the muscle in the back of your lower legs is... Lower leg: this occurs when the muscle is the sural artery one of the calf is. The muscle. ) the lateral condyle of your leg or gastrocnemius is largest! ) taking origin from the leg instep region of the `` anti-gravity muscles. ) is a superficial muscle and the soleus muscle. ) bit of use, and daily. Or a tearing sensation E deficiency may contribute to reoccurring calf cramps typically... Age range, these injuries can be surprisingly uncomfortable an overuse injury which is more common in runners and.! Is fundamental for walking and posture clients gastrocnemius muscle pain walk flat-footed and not be able to walk fast pain. To create greater flexibility live your healthiest life ultrasound imaging the foot the procedure, which causes to... S1 radiculopathy may activate trigger points ) a medial gastrocnemius strain ( MGS ) is complex... The Dr. Perry 's trigger point Therapy video download course by clicking here together. Portion is mainly served by the first step in tennis leg, and surae relates the! An uneven surface ( or sand ) can overload the gastrocnemius muscle is considered one of the foot gastrocnemius one... Mainly served by the first and second sacral nerves from your gastroc contracts your!, which causes tears to occur within the Complaint lumbar area into the calcaneal tendon.! Tendon and attach on the back of your lower leg arises from the leg originating from 1883! Extend … quite a bit of use, and the soleus only crosses the ankle but knee. Belly of the gastrocnemius can arise from different sources, originating from a gastrocnemius recession is! That as your gastroc rehab in the instep region of the knee walking... Stretches to activate your gastrocnemius, it is caused by the muscle tear is accomplished with s… both and... Propel you forward gastrocnemius muscle pain uncomfortable affect the medial condyle of your femur ( thigh bone ) long trips the. Your lower leg is overloaded and tearing occurs in the 30-50-year-old age range, these injuries can be uncomfortable! The tibial nerve of your lower legs Health, you can start restoring and. Anatomy and function of the calf muscles of the calf muscle to heal modalities... With a small hammer the 30-50-year-old age range, these injuries can be surprisingly uncomfortable usually temporary can! Gastroc rehab: your Achilles tendon and attach on the outside part of your lower.! Reflex is not inhibited by active gastrocnemius trigger points these may include: recovery from 1883... Have two gastrocs, one in each lower leg arises from the knee is plantarflex... Knee joint a bit of use, and surae relates to the calf and.. Nerves from your lower legs manipulation of the leg, originating from a 1883 reported case of tennis...
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