How to Eliminate Back Pain in 4 Simple Steps
The Rx4 Back Pain Relief System
By
Steve Crossley BSc DO D.Hyp/Psych(UK)
www.backmechanic.co.uk
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
Introduction
According to statistics, around 80% of the population suffer
from back pain at some point in their lives. After the common
cold, it is the 2nd biggest reason to be in the doctor’s waiting
room and its prevalence seems to be growing in to almost
epidemic proportions.
Unfortunately, we don’t get issued with a back owner’s manual
when we enter into this world, and so most of us have little
understanding and appreciation of just how important the spine
is to the way we function. The human spine is an incredible
piece of biological engineering and in many ways follows
mechanical and physical laws in the way it works. However,
despite advances in healthcare, medical diagnostics and human
physiology, for the average back pain sufferer, the structure,
function and maintenance of this essential piece of equipment
remains shrouded by mystery, myths and misconceptions.
Most of us are aware that when it comes to the most common
form of back pain, conventional medicine can offer no more
than temporary symptom relief at one end of the spectrum or,
at the other extreme, surgery as a risky last resort.
Fortunately, as more information becomes widely available
about natural alternatives to drugs and surgery, more and
more people are beginning to realise that there are other
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
options available to them, especially if they are prepared to
take more responsibility and learn to help themselves a little
more.
“There’s No Smoke Without Fire!”
You see, treating back pain with anti-inflammatories and pain
killers is analogous to taking the batteries out of a smoke
alarm because the noise is disturbing.
“Back pain is a warning sign that there is something
wrong with the mechanics of the spine.
In other
words, the “smoke” of back pain symptoms wouldn’t
exist without the underlying “fire” of mechanical
dysfunction.”
Just as if you were driving a car with a flat tyre and a bent
steering column, it wouldn’t give you a comfortable ride and it
wouldn’t perform efficiently. Imagine if you didn’t do anything
about it and just continued driving it around for a few
months... I’m sure you’d agree that this could only result in
more wear and tear, declining performance and of course much
bigger repair bills further down the road. It wouldn’t make any
difference how clean and shiny the car is or the quality of the
oil and fuel. Unless the mechanical problems were fixed, the
car would steadily deteriorate and would probably end up on
the scrap heap.
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
The primary reason for the generally disappointing lack of
appropriate diagnosis and treatment for chronic back pain is
that modern orthopaedic medicine doesn’t focus on maintaining
optimal structure and function of the human body, but rather
on treating the symptoms and pathology that are the inevitable
result of faulty posture and biomechanics over a prolonged
period of time.
In other words, the modern orthopaedic mechanic (surgeon),
will only try to fix you (operate) after you have broken down
badly enough to justify the risk and expense of surgery. In
fact in the vast majority of cases he will delay surgery and
suggest that you carry on running inefficiently and putting up
with the symptoms until you completely break down.
Well, I’m here to tell you that there is an alternative solution
and it doesn’t involve medical drugs, surgery or complicated
and expensive treatments, supports or gadgets.
“For far too long the mysteries, myths and
misconceptions have been hidden and I’ve made it my
mission to help as many back pain sufferers as
possible by revealing the true causes, the real
solutions and a step by step blueprint to follow for
the elimination of back pain.”
If you’re frustrated by chronic back pain that detracts from
your quality of life, I want to help you uncover the mystery of
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
your back pain and clear up all the myths and misconceptions
surrounding this all too common condition.
After more than 20 years of working with back pain sufferers, I
have evolved an effective and simple 4 step system for the
treatment and rehabilitation of back pain and dysfunction.
Introducing
The Rx4 Back Pain Relief System
Relax – Release – Realign – Restabilize
The Rx4 System addresses the following four common issues:
1. Faulty Posture
2. Muscle Imbalances
3. Spinal Instability
4. Faulty Movement Patterns
These four important and very common issues are largely
controlled and influenced by another set of factors, well known
in the field of osteopathic practice... Predisposing,
Precipitating and Maintaining Factors.
Predisposing Factors – examples: genetic disposition,
developmental anomalies, and previous injuries.
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
Precipitating Factors – examples: more recent strains or
injuries, pregnancy, childbirth, illness or even psychological
stress.
Maintaining Factors – examples: poor posture, occupational
and repetitive strain, overweight, loss of muscle tone, poor
nutrition and lifestyle.
A quick and simple example of the above principles in action
would be the following scenario based on a patient who came
to see me for the first time recently.
This young lady was a recently qualified dentist who specialised
in periodontal work (oral hygiene and care of the gums). She
was complaining of severe right sided neck and shoulder pain,
tension in her upper back and frequent headaches.
Her occupation meant that she spent most of her working
hours sat hunched over a patient with instruments in both
hands operating them inside the patients’ mouth and having to
maintain this position for several minutes at a time, all day,
every day. In this case her occupation was a considerable
maintaining factor for her symptoms because the strain,
although not extreme was repetitive and prolonged.
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
Several years previously, the lady had been in hospital for
some surgical procedures to treat a problem with her right
lung. On my examination, I found that there was still some
scar tissue in the area of the surgery which was associated with
short and tight muscles alongside the spine on the right side.
This scar tissue was restricting movement, causing muscle
shortening and creating a postural curvature known as a
scoliosis.
Having this type of misalignment and imbalance would be
considered a predisposing factor because it predisposed her to
developing mechanical dysfunction and related symptoms in
that particular part of her body. If she had suffered a broken
leg instead of a lung problem it would have been quite different
as, in the sitting position, a leg length discrepancy (a common
result of a broken leg) for example, would have little impact on
her upper body biomechanics.
Now, this is where we get to the most interesting part... The
Precipitating Factor... That is the actual event or situation that
was the trigger for her sudden and very painful episode of pain.
During my comprehensive consultation and examination I
discovered that this young lady had just moved into the area
and started her new job within the last week. Now most
people recognise that moving home and starting a new job are
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
two of the most stressful events in life and she had done both
at the same time. Not only that, but as part of her new job she
had been required to give a presentation to fellow professionals
just a few days before she came to see me. She also told me
that she had mislaid her presentation slides and had to go
rushing backwards and forwards from the venue to her car to
locate them and be able to deliver her presentation. She
admitted that it had been a particularly stressful day.
I hope you can see my point that a painful episode can be
triggered by a “precipitating factor” such as stress, particularly
when you already have any of the other controlling factors
present. In this case they were the predisposing factor of her
previous lung surgery and the maintaining factor of her
occupational repetitive strain.
Now, I could also mention other controlling factors that were in
operation in this case, such as being right handed, but those
were the most significant ones and hopefully, you can see how
they are all inter-related in this type of scenario and also just
how the cumulative effect of these factors could lead to some
kind of crisis.
“The nerves, muscles and joints of the body are all
closely linked - anything that affects one will also
have an effect on the others”.
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
Having given you my take on the causes and controlling factors
relating to back pain, now I’ll finally give you the solution...
Here’s my 4 step system for avoiding, reducing and eliminating
back pain –
The Rx4 Back Pain Relief System
Relax – Release – Realign – Restabilize
The Four Simple Steps of the Rx4 System are:
1. Relax Muscle Spasm and Trigger Points
2. Release Locked and Restricted Joints
3. Realign The Spine - Correct Postural Faults
4. Restabilize The Spine - For Lasting Relief
Step 1. Relax Muscle Spasm
“mysteriously, muscles cause most of the worlds pain!”
When it comes to the painful symptoms of back pain, muscle
spasm is by far the biggest factor because it creates a selfperpetuating vicious cycle of spasm-pain-spasm. The nervous
system controls the amount of tension in muscles and will react
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
to protect itself from damage by causing a reflex contraction of
muscles surrounding injured or unstable joints. It is important
to break this cycle by relaxing any active trigger points
involved in the process of back pain.
The relaxation of muscle spasm is the fastest way to reduce
pain and also to improve mobility. This is why massage, heat,
stretching and gentle exercise often seem to make a bad back
feel better. Unfortunately, the effect is often short lived
because muscle spasm is only one of the 4 components of
healthy spinal mechanics.
You’ve probably heard of the term fibrositis... This occurs in
muscles that have become weakened through a gradual
lengthening process. The body tries to thicken the muscle
fibres and connective tissues of a stretched and weak muscle,
producing fibrous knots in the tissues which can become very
tender and painful to pressure. These fibrous knots are known
as trigger points because they can trigger pathways of pain
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
through the network of connective tissues, affecting many
other muscles and producing considerable pain and
dysfunction. Here’s what one enlightened independent
researcher says about the importance of muscles and trigger
points in musculo-skeletal pain.
Muscle tissue is the largest organ in the body,
metabolically active and filled with nerves, the
“primary target of the wear and tear of daily
activities, but it is the bones, joints, bursae and
nerves on which physicians usually concentrate their
attention.”
Doctors are generally unaware of musculoskeletal
health care — it simply isn’t on their radar. “Muscle
is an orphan organ. No medical speciality claims it.”
Step 2. Release Joint Restrictions
Spinal misalignment and its associated muscle imbalance leads
to reflex protective contraction of surrounding muscles. This in
turn leads to compression and restrictions in normal joint
movement, resulting in compensatory faulty movement
patterns.
Most of us are familiar with the clicking and cracking sounds
our joints make when stretched and released, and there is
usually a satisfying feeling of increased relaxation and mobility
for a while afterwards. Restricted joints can be released in
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
various ways including osteopathic or chiropractic manipulation
and sometimes with stretching and mobilising techniques and
exercises.
Most forms of physical therapy for back pain focus on one or
the other of these first two steps (relax muscles and release
joints) and sometimes that is enough for relief of the painful
symptoms. In many cases however, the pain returns quite
quickly, or is triggered by specific activities or postures like
sitting in a car or at a desk for any length of time, or lifting
something that you’re not used to lifting on a regular basis.
Step 3. Realign the Spine
If the posture and alignment of the spine are deviating away
from optimal balance for any length of time (as is the case for
most of us these days), muscle imbalance, trigger points, pain
and restriction are as sure to develop just as night follows day.
We all know that it’s a good thing to have good posture, but
having that awareness doesn’t automatically create or maintain
it. Our habits, past-times and occupations increasingly cause
us to be in unnatural positions for lengthy periods of time,
during which, adaptive shortening of some muscles takes place
and lengthening and weakening of their antagonists is a natural
consequence. The long term result of this imbalance is
misalignment and postural deterioration.
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
One important consideration to bear in mind when practicing
any postural improvement method such as yoga, Pilates or the
Alexander technique for example, is to determine whether the
exercises being done are addressing your own particular
pattern of misalignment.
Whenever there is postural imbalance and misalignment, there
are always certain muscles that are weak and others that are
strong. Usually these work as pairs in conjunction with each
other on opposite sides of a joint or series of joints such as the
spinal column.
Let’s use the hamstrings and quadriceps muscles of the upper
leg as a simple example. In the sitting position the hamstrings
at the back of the thigh are in a shortened position and the
quadriceps at the front of the thigh are in a lengthened
position. In this case the hamstrings are known as the agonist
muscles and the quadriceps as the antagonist muscles.
Now, over time and with prolonged and repetitive sitting such
as in a car or at an office desk, the agonist muscles become
shorter and tighter and the antagonist muscles become longer
and weaker. The way the nervous system tries to cope with
this type of muscle imbalance is to change the way the muscles
function in an attempt to correct the imbalance.
The concept of correcting muscle imbalance is simple enough.
All you need to do is stretch the short and tight muscles and
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
strengthen the long and weak ones. The muscular system
controls alignment and posture and it is impossible to improve
postural alignment without improving the length-tension
relationships of the muscles.
Having the knowledge and ability to accurately assess and
measure postural balance and alignment requires specialized
training and measuring equipment along with a thorough
understanding of functional anatomy. For example, the
optimum angle of anterior/posterior tilt of the pelvis is different
for males compared to females and is a major factor in
determining whether tight hamstrings should be stretched or
strengthened. Yes, it’s possible (and very common) for tight
hamstrings to actually be too long and weak.
I’m positively in favour of any means of improving posture and
biomechanical function, but each of us is unique and we all
have our own particular postural patterns. For this reason, an
individualized postural and biomechanical assessment and a
custom designed corrective exercise programme would always
be my recommendation alongside any physical therapy as a
foundation for long term spinal health.
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
The above illustration is a simple example of a common type of
postural dysfunction. There are several different types of
postural dysfunction that are also commonly recognized
including the flat-back and the sway-back postural types.
So, how do you go about realigning a crooked spine?
“Well, the first place to start is with the muscular
system.
Just like the guy ropes that support a tent,
the muscles need to be balanced to support a healthy
spine. It is most important to correct muscle
imbalances first if you are to avoid back pain and
joint problems in the long term.”
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
The 4th and final step in the Rx4 Spinal Anti-Aging System is
the most vital when it comes to protecting the spine from
strain and injury.
Step 4. Restabilize The Spine
Whether you are a competitive athlete, a recreational sports
enthusiast, or just someone who wants to avoid back pain and
have a healthy spine that lasts a lifetime, you need stability.
The term core stability has become widely quoted and
recognised over the last few years, especially in the fields of
sports conditioning, exercise physiology and spinal orthopaedic
rehabilitation. But what if you’re a regular, non-medical and
not especially athletic back owner who wants to eliminate or
avoid back pain? What do you need to know about
understanding and achieving this Holy Grail in the spinal antiaging quest?
Well, without going into too much technical detail about the
anatomy, physiology and science of core stability (whole
training courses have been created around this one subject),
I’d like to use a metaphorical quote to put the concept in a
nutshell.
“You can’t fire a cannon from a canoe!”
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
To be able to fire a cannon with consistent accuracy, it needs
to be operating from a stable base of support. The power and
force created by what is basically a contained, controlled and
directed explosion is enough to propel a heavy missile or ball of
metal a considerable distance with great velocity. We’ve all
seen film clips demonstrating the huge recoil of a military
cannon when it is fired and you can imagine the effect of that
recoil on the canoe and the trajectory of the missile if it
actually was fired from a canoe.
There are many factors involved in how efficiently an individual
can control his or her spinal stability, including (perhaps
surprisingly), general health and digestive system function.
However, it basically comes down to neuro-muscular strength,
control and co-ordination and whether the individual is able to
maintain and control their centre of gravity over a base of
support that may be unstable at times.
All movement emanates from the core, which means that even
when simply walking, the movement of alternately placing one
foot in front of the other is initiated by the muscles which
stabilize the spine around the body’s centre of gravity
(approximately at the level of the navel), so that the bridge
between the upper and lower body is a stable and secure link.
In many cases of low back pain and dysfunction, the core
muscles are the weakest link in the kinetic chain which is why
people often hurt their back whilst carrying out a simple
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
movement or activity. A racing car could have the most
powerful engine, but if it’s not securely attached to a strong
and stable framework it’s likely to fall apart at the first high
speed bend.
Most exercise programs do not recognize the importance of this
key area and are often lacking in any reliable form of core
stability assessment and also therefore, the correct prescription
and progression of appropriate exercises.
I have noticed that many people starting a new gym based
exercise program are often afraid to do anything strenuous
that involves their spine in the gym, so they subconsciously
guard and protect their back thinking that they are better being
safe than sorry. It is also very common for new gym trainers
to develop a painful problem or injury within a few weeks of
starting such a program.
“The most commonly mistaken attitude around this
issue is that using gym equipment and lifting weights
is dangerous, so unless you’re a “real athlete”, it’s
best to stick with “safe” exercises such as the
stationery bike, the treadmill, or if you’re feeling
adventurous, maybe the cross trainer.”
The problem with this approach is that the typical modern gym
based “one dimensional” types of exercise do little to improve
core strength and stability, so they do not improve the
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
individuals’ functional capacity when it comes to coping with
the physically demanding situations presented to them in real
life.
If you want a back that is strong, mobile, stable and pain free,
you need to condition it in a scientific and progressive manner.
If you just continue trying to avoid strain and subconsciously
guard your spine (the nervous system can become very
efficient at keeping your spine on red alert), you can never get
past the first hurdle of actually improving your spinal
biomechanics, and the important structures remain weak,
immobile and fragile.
As Albert Einstein was famously quoted as saying,
“the definition of insanity is repeating the same
behaviour over and over again, expecting to get a
different result”
If you continue to do what you’ve
always done, you’ll continue to get the same results
that you’ve always got!
This is why I firmly believe it is important to assess the core to
identify where any weak links in the kinetic chain exist and to
establish a starting point for corrective exercise programming.
So, I encourage you to think about your own body’s mechanics
for a moment. Think about all the factors that we’ve discussed
and ask yourself these questions...
© 2010 – Steve Crossley – All Rights Reserved
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How to Eliminate Back Pain in 4 Simple Steps
“Is my body a wreck that’s ready for the scrap heap,
or am I just out of balance and in need of a good
service and tune-up?”
“Would I feel and perform better if my muscles and
joints worked more efficiently?”
“If I found a “back mechanic” with the right skills,
knowledge and experience, would I be prepared to
invest in improving the way my body works?”
Conclusion
So, now you have the blueprint for the elimination of back pain
and the ownership of a spine that was designed to function like
a well oiled machine and to last a lifetime. The question
is...Are you going to make use of this information and do
something about it, or just let it gather dust somewhere?
“If these principles are applied and practiced in the
right manner, I believe it is possible for 95% of
back pain sufferers to be able to eliminate their
pain and live an active and productive life.”
I know that some parts of this system require the help of a
suitably trained and qualified professional, so I would urge you
to make some enquiries and ask questions to find the right
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
practitioner for whichever phase of the Rx4 system you are
concentrating on. If you’re lucky, you may find someone who
understands the big picture and can assist you through each
stage.
The above 4 simple steps to eliminating back pain are the basic
elements of a concept of optimal spinal biomechanics and
functional rehabilitation that has taken me most of my 23 year
career in physical therapy to evolve.
This process of evolution has been my primary interest and has
been shaped and influenced by many books, courses, teachers,
revelations and understandings, and it has been honed and fine
tuned in the laboratory of the treatment room with my patients
as my test subjects.
There’s no substitute for real-world experience and I’m
eternally grateful to them all for allowing me the opportunity to
practice and develop my work whilst helping people and
changing lives for the better.
“I consider the human being to be the ultimate
expression in the process of natural evolution and
believe that the healing power of nature is the
wisest and most effective doctor available to us.”
Although my primary professional qualification is as an
osteopath and I hold the original osteopathic philosophy to be
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
the most holistic and complete, I do not believe that
osteopathic manipulative techniques alone are always sufficient
to ensure long term spinal health. Equally, I don’t believe that
any other single discipline or therapy has all the answers
either.
Perhaps one day there will be a new kind of physical therapy
practitioner who will be trained to specialize in treating back
pain by integrating all of the relevant knowledge, skills and
techniques incorporated in the Rx4 System...
Relax – Release – Realign – Restabilize
About The Author
Steve Crossley is an osteopath, health and
exercise coach and psychotherapist based
in Eastbourne in the UK. He has more than
20
years
experience
in
working
with
individuals from all backgrounds who want
to improve their physical and mental health
and performance.
Steve has practiced and enjoyed many sports and physical
activities over the years including running half-marathons,
windsurfing and golf. Through his passion and commitment in
training the body to a high level of performance, has also been
a champion competitive bodybuilder.
© 2010 – Steve Crossley – All Rights Reserved
www.backmechanic.co.uk
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How to Eliminate Back Pain in 4 Simple Steps
His fascination for the human mind as the conductor of the
physical orchestra has also taken him in the direction of
hypnotherapy, psychology and personal development which he
integrates with his skills in physical therapy to help his clients
get the maximum from their time with him.
If you would like to know more about how to improve your
health, mental and physical performance with time-tested and
proven natural methods, please pay a visit to my website at:
http://www.backmechanic.co.uk, where you can browse my
other books and products and subscribe to my regular
newsletters for valuable health tips, special offers,
recommendations and even ask me your most burning health
and back pain related questions.
Thanks for reading this report, I hope you found it interesting
and helpful.
All the best,
Steve Crossley
© 2010 Copyright Steve Crossley
ALL RIGHTS RESERVED. No part of this report may be reproduced or transmitted in any form
whatsoever, electronic, or mechanical, including photocopying, recording, or by any informational
storage or retrieval system without express written, dated and signed permission from the author.
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