Pain In The Foot's Arch All The Things You Want To Learn

Overview


One of the most common foot maladies people suffer from is plantar fasciitis. This condition arises when undue stress is placed on the ligament in your foot that supports your arch, the "plantar fascia". When that ligament is overworked it leads to the classic symptoms of heel and arch pain which worsens when you get up to walk after periods of rest. This isn't the kind of pain you experience after being on your feet all day at work or walking around Disneyland with your kids. The pain from plantar fasciitis is often intense and debilitating. It is also surprisingly common. Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.


Arch Pain


Causes


Flat feet are often hereditary. Arch pain may also be caused by wearing shoes with inadequate support, standing or walking for long periods of time in high heels, or overuse of the feet during work or sports. Being overweight also places additional stress on the feet, especially the arches.


Symptoms


Arch pain symptoms could include any of the following, a dull, constant ache if the ligaments have been stretched, swelling or tenderness in the foot, redness or bruising in the event of a more serious injury, difficulty putting weight on the foot, sharp pain when the foot is turned or manipulated, tenderness when pressure is applied. Because the arch of the foot is such a complex structure, arch pain could be an indicator of several different types of injuries. Chronic illnesses such as arthritis could also cause arch pain, and depending on the cause or source of your pain, you may experience discomfort in a variety of different areas. Ask a doctor if you believe you may have injured your foot arch.


Diagnosis


The medical practitioner will examine how the muscles of your foot function. These tests may involve holding or moving your foot and ankle against resistance; you may also asked to stand, walk, or even run. Pain caused by movements may indicate the cause of the pain. The nerves in the foot will be tested to make sure no injury has occurred there. An x-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are changes in the makeup of the bone.


Non Surgical Treatment


Anti-inflammatory medications such as ibuprofen and aspirin can provide short-term relief from foot pain associated with fallen arches, notes the American Academy of Orthopaedic Surgeons. Doctors sometimes inject the foot with a corticosteroid medication, which acts as an anti-inflammatory, to relieve acute pain. Although medications can provide symptom relief, they do not correct the underlying foot abnormality.


Arch Pain


Surgical Treatment


Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg or ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done.


Stretching Exercises


Strength training and stretching can help avoid injury and keep your feet free from pain. Stretching should focus on the bottom of your foot to loosen tissues and tight ligaments surrounding your arch. The easiest way to do this is by grabbing a towel and sitting on the floor. You can do this while you catch up on the news in the morning, or when you get home from work. Put one leg out in front with your foot flexed up. Loop the towel around the ball of your foot and gently pull your toes towards you. Hold for thirty seconds and then repeat 3-4 times before switching feet.

Which Tend To Be The Major Brings About Regarding Adult Aquired Flat Foot ?

Overview


This condition is characterized by a progressive flattening or even falling of the arch. The idea is actually often referred to end up being able to as posterior tibial tendon dysfunction (PTTD) and is becoming a way more typically acknowledged foot problem. Since the particular situation develops more than time, it is normally diagnosed throughout adulthood. It generally merely develops in a foot though it can affect both. Since it is progressive, it is typical for signs for you to worsen, specifically when it isn't treated early. Your posterior tibial tendon attaches to the bones on the inside of one's foot and it is important towards the support construction within the actual foot. Along With PTTD, changes inside the tendon impair its capability to function normally. the outcome is less support for that arch, which usually in turn leads to it to fall or even flatten. Any flattening arch may cause your heel to shift from alignment, the forefoot to always be able to rotate outward, the actual heel cord to tighten, along with possible deformity of the foot. common symptoms consist of pain over the inside of the ankle, swelling, an inward rolling with the ankle, pain that is a whole lot worse together with activity, along with joint pain as arthritis sets in.


Flat Foot


Causes


Rheumatoid arthritis This kind of arthritis attacks the particular cartilage within the foot, ultimately causing pain as well as flat feet. The idea is due to auto-immune disease, where the body?s disease fighting capability attacks its extremely own tissues. Diabetes. Getting diabetes may cause nerve damage along with affect the sensation within your feet as well as cause arch collapse. Bones can easily furthermore fracture however, many patients may well not really feel any pain credited to the nerve damage. obesity and/or hypertension (high blood pressure) This kind of raises your current likelihood of tendon damage and also resulting flat foot.


Symptoms


Not everyone using adult flatfoot provides problems with pain. These who do usually feel it across the ankle as well as inside the heel. The Actual pain is typically a whole lot worse together with activity, similar to strolling or even standing regarding extended periods. Sometimes, if the issue develops through arthritis inside the foot, bony spurs over the leading along with facet in the foot develop and also help to make wearing shoes much more painful. Diabetic patients must watch regarding swelling or perhaps big lumps in the feet, because they might not notice just about any pain. They Will are also with higher risk regarding developing significant deformities from their particular flatfoot.


Diagnosis


The history and physical examination are probably the most crucial tools the actual physician utilizes to diagnose this problem. Your wear pattern in your shoes can provide some beneficial clues. muscle screening helps identify virtually any areas regarding weakness or muscle impairment. This should be completed inside both the physique weight bearing along with nonweight bearing positions. a very effective test may always be the single heel raise. Anyone is likely to be inspired to climb onto 1 foot and arise on your toes. A Person ought to be able to be capable of lift the heel off the ground simply while maintaining your calcaneus (heel bone) inside the middle together with slight inversion (turned inward). X-rays in many cases are utilized to study the actual position, shape, and alignment of the bones inside the feet as well as ankles. Magnetic resonance (MR) imaging is the imaging modality of choice regarding evaluating your posterior tibial tendon along with spring ligament complex.


Non surgical Treatment


Treating PTTD is nearly often easier the earlier anyone catch it. So, the very first step in therapy is to call in your physician as quickly when you begin experiencing painful symptoms. However, once your own issue has been diagnosed, your podiatrist will most likely try to give the upset tendon the bit of your break so it?ll calm down preventing getting thus painful. This can get accomplished simply by immobilizing the foot using tape and also padding, braces, or perhaps casts, depending about what your own podiatrist believes will still work perfect for you, and also depending on the severity of one's condition. A Person might also end up being instructed to lessen inflammation through the employment of ice to the area (usually 40 minutes upon as well as twenty minutes off, with a thin


towel between you and the ice). Or, you could consider anti-inflammatory medications similar to ibuprofen (steroidal anti-inflammatory meds are actually most likely to make this challenge worse, as well as aren't typically advised throughout treating PTTD), or even use ultrasound therapy. When the inflammation features gone down a bit, the podiatrist may recommend making use of orthotics (prescription shoe inserts) to guide the damaged arch. Ankle braces could be also helpful.


Adult Acquired Flat Foot


Surgical Treatment


Surgical therapy ought for you to be considered when most some other conservative treatment method features failed. Surgery choices for flatfoot reconstruction depend around the severity of the flatfoot. Surgery to get a flexible flatfoot deformity (flatfoot with out arthritis for the foot joints) involves advancing the actual posterior tibial tendon below the actual arch to offer much more support as well as decrease elongation in the tendon too as addressing the hindfoot eversion having a osteotomy for the calcaneus (surgical cut within the heel bone). Additionally, the actual Achilles tendon might need being lengthened since with the compensatory contracture in the Achilles tendon using flatfoot deformity. Flatfoot deformity together with arthritic changes for the foot is considered a rigid flatfoot. Correction of your rigid flatfoot deformity generally involves surgical fusion of the hindfoot joints. This particular is actually a reconstructive procedure that allows the particular surgeon in order to re-position the foot into a normal position. Although the actual procedure should be considered with regard to advanced PTTD, it has numerous complications and should become discussed at length together using your doctor.

All You Want To Find Out Regarding Arch Pain

Overview


The arch functions as a shock absorber for our entire body. Each time we step down, we place up to 5 times our body weight on the foot, depending on whether we are walking, running, or jumping. If there were no shock absorber in the foot, the force of each step would fracture or dislocate the bones of the foot, leg, and lower back. When pain occurs in the arch, it is telling us it is "sick" and cannot function properly. If left untreated, it can cause constant pain throughout the entire foot, and eventually the knee, hip, and lower back.


Foot Arch Pain






Causes


Plantar Fasciitis is commonly the cause of most arch pain. The bands of fibrous tissue in the arches of the feet become inflamed. Plantar Fasciitis is associated with early morning arch pain, from the plantar fascia tightening and contracting during the night when there is no strain on the bands. Arch pain occurs when there are extended periods of standing or walking, resulting in prolonged tension on the plantar fascia which in turn causes inflammation and irritation. While plantar fasciitis normally affects middle aged men and women, younger athletes are affected by arch pain because of the repetitive movement of certain sports, which causes damage to the fibrous tissue.






Symptoms


Pain in arch of foot is really the only symptom of this condition. It is unlikely to see any swelling or bruising and instead there will be a deep tender spot near the heel. Occasionally the pain may radiate further down the foot. With this condition, pain will usually be felt first thing in the morning or after periods of sitting. This is because the plantar fascia tightens and shortens slightly when there is no weight on it and by standing on it it suddenly stretches and becomes painful. After a few steps it starts to loosen off and the pain may subside. If this is the same pattern of pain you experience it is quite likely you have plantar fasciits. Pain may also be felt when walking up stairs or standing on tip-toes (anything that stretches the fascia).






Diagnosis


Flat feet are easy to identify while standing or walking. When someone with flat feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat feet because their arches may not fully develop until they're 10 years of age.






Non Surgical Treatment


Anti-inflammatory medications such as ibuprofen and aspirin can provide short-term relief from foot pain associated with fallen arches, notes the American Academy of Orthopaedic Surgeons. Doctors sometimes inject the foot with a corticosteroid medication, which acts as an anti-inflammatory, to relieve acute pain. Although medications can provide symptom relief, they do not correct the underlying foot abnormality.


Arch Pain






Surgical Treatment


Tendon transfers: Too much pull of certain muscles and tendons is often the cause of the deformity related with a cavus foot. Moving one of these muscles or tendons may help the foot work better. In addition, patients with a cavus foot may have weakness in moving the foot up, which is sometimes called a foot drop. In these cases, a tendon from the back of the ankle may be moved to the top of the foot to help improve strength. Correcting the deformity of the foot may not be possible with soft tissue procedures alone. In these instances, one or more bone cuts (osteotomies) may be needed. Instead of a bone cut, a fusion (arthrodesis) procedure may be used. A fusion removes the joint between two bones so they grow together over time. During a fusion the bones may be held in place with plates or screws. Calcaneal osteotomy: This procedure is performed to bring the heel bone back under the leg. This is needed if correction of the deformity in the front of the foot does not also correct the back of the foot or ankle. A calcaneal osteotomy can be performed several ways and is often held in place with one or more screws. Sometimes patients have a deformity that has caused damage to the joints. In these cases, soft tissue procedures or bone cuts may not be enough, and it may be necessary to eliminate the joint. Clawed toes are a common problem with cavus foot deformity. This can be treated with tendon surgery, fusion or removal of part of the toe bones. Following surgery the toes are often temporarily held in place with pins.






Stretching Exercises


Inchworm. Stand with your weight on one foot. Raise the metatarsal heads of the unweighted foot while you pull its heel closer to your toes. Next, raise your toes toward the ceiling, and then relax your whole foot with it flat on the floor. Your foot should move like an inchworm across the floor. Reps 6-7 for each foot. Horsepawing. Stand with your weight on one foot and the other foot slightly in front of you. Raise the metatarsal heads on the front foot. Lift your heel ever so slightly off the ground, maintaining the raised metatarsal heads, and pull your foot toward you so that it ends up behind you. Return this foot to the starting position in front of you. You should really feel this one in your arch. Reps. 6-7 for each foot. Toe pushups. Sit in a chair with your feet resting on the floor. Raise your heel as high as you can while keeping your toes flat on the floor. This is the starting position. Using your toe muscles, roll your foot upward until the weight of your foot is resting on the ends of your toes, like a dancer standing on point in toe shoes. Roll back down to the starting position. Reps. 10-20 for each foot. Sand scraping. Pretend you are at the beach standing in loose sand. Use your big toe to pull sand inward toward your body, with your little toe off the ground. Then use your little toe to push it away, with your big toe off the ground. Reps. 10 for each foot. Now reverse the exercise: pull the sand inward with your little toe and push it away with your big toe. Reps. 10 for each foot.

Pain In The Arch Causes Symptoms And Treatments

Overview


Fallen arches, also known as flat feet or pes planus, may be present at birth or develop later in life. The midfoot normally exhibits a slight arch, keeping this region raised during walking. Absence of the normal arch causes flattening of the sole. Many people with fallen arches have no associated symptoms, while others experience foot pain or fatigue. Treatment for fallen arches depends on the severity of the condition and associated symptoms.


Arch Pain






Causes


The arch of the foot is a very complex structure, consisting of multiple bones and ligaments. Most causes of arch pain are related to the anatomy of the arch and the types of physical activity that you perform. For example, a classic set up for arch pain is people who engage in lots of high impact exercise (such as running) while wearing a type of athletic shoe that does not properly support their type of foot arch.






Symptoms


Intense heel pain, especially first thing in the morning and after a long day. Difficulty walking or standing for long periods without pain. Generally, the sharp pain associated with plantar fasciitis is localized to the heel, but it can spread forward along the arch of the foot and back into the Achilles tendon. While severe cases can result in chronic pain that lasts all day, the most common flare ups occur first thing in the morning, making those first steps out of bed a form of torture, and in the evening after having spent a day on your feet. Overpronation (a foot that naturally turns too far inward), high arches, and flat feet (fallen arches) can all cause similar arch pain. In these cases, however, the pain is more likely to continue throughout the day rather than being worst in the morning.






Diagnosis


In a person of any age, the doctor will ask about occupational and recreational activities, previous foot trauma or foot surgery and the type of shoes worn. The doctor will examine your shoes to check for signs of excessive wear. Worn shoes often provide valuable clues to gait problems and poor bone alignment. The doctor will ask you to walk barefoot to evaluate the arches of the feet, to check for out-toeing and to look for other signs of poor foot mechanics.






Non Surgical Treatment


Cortisone, a type of steroid, is a powerful anti-inflammatory medication. It can be injected into the plantar fascia to reduce inflammation and pain. Your doctor may limit your injections. Multiple steroid injections can cause the plantar fascia to rupture (tear), which can lead to a flat foot and chronic pain. Supportive shoes and orthotics. Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a significant amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or insert reduces this tension and the microtrauma that occurs with every step. Soft silicone heel pads are inexpensive and work by elevating and cushioning your heel. Pre-made or custom orthotics (shoe inserts) are also helpful. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone. Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on stretching your calf muscles and plantar fascia. In addition to exercises like the ones mentioned above, a physical therapy program may involve specialized ice treatments, massage, and medication to decrease inflammation around the plantar fascia. Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. ESWT has not shown consistent results and, therefore, is not commonly performed. ESWT is noninvasive-it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.


Foot Arch Pain






Surgical Treatment


The procedure involves cutting and shifting the bone, and then performing a tendon transfer. First, the surgeon performs a calcaneal osteotomy, cutting the heel bone and shifting it into the correct position. Second, the surgeon transfers the tendon. Reroute the flexor digitorum to replace the troublesome posterior tibial tendon. Finally, the surgeon typically performs one or more fine-tuning procedures that address the patient?s specific foot deformity. Often, the surgeon will lengthen the Achilles tendon because it is common for the mispositioned foot to cause the Achilles to tighten. Occasionally, to increase the arch, the surgeon performs another osteotomy of one of the bones of the midfoot. Occasionally, to point the foot in a straightforward direction, the surgeon performs another osteotomy of the outside portion of the calcaneus.






Prevention


The best method for preventing plantar fasciitis is stretching. The plantar fascia can be stretched by grabbing the toes, pulling the foot upward and holding for 15 seconds. To stretch the calf muscles, place hands on a wall and drop affected leg back into a lunge step while keeping the heel of the back leg down. Keep the back knee straight for one stretch and then bend the knee slightly to stretch a deeper muscle in the calf. Hold stretch for 15 seconds and repeat three times.






Stretching Exercises


Easy Beginner Version. Start with your bare foot on a flat surface, toes spread out. Place a penny under the ball of your foot and the end of a pen under the middle of your arch (sticking out from the inside of your foot). Activate your arch by flexing your arch muscle. You should feel the muscles on the ball of your foot pushing down on the penny, but your arch shouldn't be pushing down on the pen. These tools help you (1) avoid rolling your foot and (2) avoid pressing down with your toes (as an extra tip, you can slide a business card under your toes before doing the exercise-when you activate your arch, you should be able to slide the business card out easily with your fingers). Do your best to keep your toes relaxed. Advanced Version. Once you're ready to move on, you can try this advanced version. It builds on the above exercise to incorporate full body twisting and balance, helping you to maintain proper arches while you move. Using the same ideas from above, stand on a flat surface in your bare feet with a penny under the ball of your foot and the end of a pen under your arch. This time, stand with your back a few inches away form a wall or a door. Lift your other leg (the one without the penny or pen) and stand on one foot. Use the wall for balance, if necessary. Lift one arm and stretch it across your body until you touch the wall or door on the opposite side, maintaining a straight back. Keep your foot straight and your arch on the penny but above the pen. Your arch will want to follow the movement and roll off, but you will need to activate it to stay stable during the movement. Lift your other arm and stretch it across the opposite side of your body, still keeping your arch in place.

Have I Suffered An Achilles Tendon Rupture

Overview


Achilles Tendonitis


An Achilles tendon injury can affect each expert and also amateur athletes. The Particular Achilles tendon can be certainly 1 of the more time tendons within your body, stretching in the bones of one's heel to your calf muscles. Anyone can appear it, a springy band associated with tissue from the trunk of one's ankle and also over your own heel. This enables you to extend the foot and also point your toes towards the floor. Unfortunately, it's a typically injured tendon. Several Achilles tendon injuries tend for you to be brought upon by tendinitis, in which the particular tendon gets swollen and painful. Inside any severe Achilles tendon injury, an excessive amount of force about the tendon can cause it in order to tear partially or even rupture completely.






Causes


Common brings about of an Achilles tendon rupture are the progression involving or perhaps the final result of longstanding Achilles tendonitis or possibly an overuse injury. An injury towards the ankle or maybe a immediate blow to the Achilles tendon. Since a outcome of a fall exactly where an individual lands awkwardly or immediately around the ankle. Laceration with the tendon. Weakness in the gastrocnemius as well as soleus muscles within individuals with existing Achilles tendonitis locations elevated tension around the tendon. Steroid use continues to be connected to tendon weakness. Specific systemic diseases happen to be connected with tendon weakness. a sudden deceleration as well as stopping motions that will trigger an acute traumatic injury with the ankle. Injection associated with steroids towards the involved tendon or the excessive use associated with steroids may be proven to weaken tendons and cause these in order to become susceptible in order to rupture. Contraction with the calf muscles even even though the foot is actually dorsiflexed (pointed towards the particular head) and the lower leg is relocating forward.






Symptoms


The most typical initial symptom of Achilles tendon rupture is a sudden snap at the rear with the heels using intense pain. Instantly following the rupture, nearly all people will have challenging walking. A Few people might have got had previous complains involving calf or even heel pain, suggesting prior tendon inflammation or perhaps irritation. Instantly right after an Achilles tendon rupture, most people will develop a new limp. in addition, if the ankle is moved, the affected person will complain of pain. Inside most cases, your affected ankle will have no strength. once the actual Achilles tendon can be ruptured, the average person won't become able to run, climb up the actual stairs, or perhaps climb onto his toes. The Particular ruptured Achilles tendon prevents the energy from your calf muscles to go your heel. Anytime your diagnosis can be missed, the actual recovery will be usually prolonged. Bruising as well as swelling across the calf and ankle occur. Achilles tendon rupture will be frequent throughout elderly people that possess a sedentary lifestyle as well as suddenly grow for a person to be active. Within these individuals, the particular tendon isn't strong and also the muscles tend to be deconditioned, generating recovery much more difficult. Achilles tendon rupture continues to end up being able to be reported after injection involving corticosteroids across the heel bone or perhaps attachment with the tendon. Your fluoroquinolone class regarding antibiotics (such as ciprofloxacin [Cipro]) can be recognized to trigger Achilles tendon weakness and rupture, specifically in younger children. some individuals have stood a prior tendon rupture which was managed conservatively. Within such cases, recurrence associated with rupture is very high.





Diagnosis


During the actual physical exam, your healthcare professional will inspect your lower leg regarding tenderness along with swelling. Within many cases, doctors can appear any gap inside your tendon if it features ruptured completely. The Actual physician might also have you kneel on the chair or even lie on your current own stomach together along with your feet hanging over the conclusion associated with the exam table. He or perhaps the girl may then squeeze the calf muscle to find out if the foot will immediately flex. When it doesn't, you the vast majority of likely have got ruptured the Achilles tendon. If there's a new problem concerning the extent of one's Achilles tendon injury, whether as well as not it's entirely as well as only partially ruptured, your healthcare professional may order an ultrasound or perhaps MRI scan. These kind of painless treatments generate images in the tissues of your body.






Non Surgical Treatment


There is no definitive protocol regarding conservative management. Traditionally, conservative remedy concerned immobilisation inside a cast or even boot, together with initial non-weight bearing. Recently, good results are already achieved along with functional bracing and also early mobilisation, plus it is common to be right away weight-bearing within an orthotic. Conservative management reduces the opportunity regarding complications, like infection. Right now there is a danger the actual tendon could heal too much time plus more slowly.


Achilles Tendonitis






Surgical Treatment


This injury is actually usually handled surgically. Surgical care adds the risks associated with surgery, you may find for you to end up being in a new position to definitely view. after your surgery, your cast as well as aftercare is normally as follows. A New below-knee cast (from just beneath the actual knee for the tips in the toes) can be applied. The Particular original cast might always be applied with your foot positioned in a downward direction to be in the position to allow the ends with the tendon to lie closer collectively with regard to first healing. you could be brought back in 2-3 week intervals until the foot could be positioned in 90 degrees towards the leg inside the cast. The extremely first about six weeks within the cast are typically non-weight bearing with crutches or another suitable device for you to assist with the non-weight bearing requirement. after 6 weeks inside the non-removable cast, a new removable walking cast is actually started. Your removable strolling cast can end up being taken off for therapy, sleeping and bathing. The Actual time period inside the removable walking cast might need to last to have an further 2-6 weeks. your physician will review a property physical therapy plan with you (more upon this program later) that will typically commence not long after your non-removable cast will be removed. Your Own doctor might also refer a person with regard to formal physical therapy appointments. Typically, weight bearing exercise activities are usually kept restricted pertaining to a minimum of 4 several weeks or more. Swimming or perhaps stationary cycling actions might always be allowed sooner. complete healing may take 12 months or perhaps more.






Prevention


Here are the handful of suggestions to assist to avoid this injury. Corticosteroid medication for example prednisolone, ought in order to be employed carefully as well as the dose ought to always be in any position to be reduced if possible. Nevertheless note which there are many circumstances where corticosteroid medication is essential or lifesaving. Quinolone antibiotics needs to be employed carefully throughout individuals previous over 60 or who're getting steroids.
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Eugena Plungy

Author:Eugena Plungy
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