A tibial compression test is something performed to diagnose a torn ACL in dogs. To achieve this, it would be best that before going to sleep, you remove the old bandages carefully, clean the wound with an antiseptic solution, apply a healing ointment over your wound, and then wrap the wound with fresh and clean bandages. After ACL surgery, patients are typically instructed to wear a knee brace for several weeks or months. Correct posture means standing up straight with your weight centered over your feet, maintaining the natural curves in your spine. Sleeping aids may be provided if you require them, but these aids may be reduced as you heal. Work toward being able to fully straighten (achieve full extension) of your injuredleg, Develop good quadriceps control and strength. Heel raises improve calf strength. for a few weeks prior to your surgery to avoid losing more sleep over the new Use a pillow (s) between your knees to avoid crossing your surgical leg across the middle of your body. Lift your top leg using your hip, not your back or side. Try not to lean. Before having ACL reconstruction surgery, your doctor may order tests to help assess the level of your injury. Relax and then retighten the muscle and perform another repetition. Your PT may suggest a, Posture and gait training with or without assistive devices, Pivoting techniques to decrease the risk of injury. These help promote wound healing during post-op recovery. your tibia (one of the two bones in your lower leg), the ACL is a key component It is important to note that these symptoms must not be ignored as they demand immediate medical attention. The anterior knee joint can be partially or completely torn, as in athletes. Focus on using the quadriceps muscles and. . Sometimes, patients ignore these crucial symptoms because the pain and swelling tend to reduce with time, and patients attempt to return to sports which unstabilizes the knee joint and aggravates the injury; causing severe damage. Learn the type and extent of the injury to your ACL and surrounding tissues. Let your foot hang off the end of the bed or table for 20 -30 minutes three to four times each day. Hold this bent-knee position for five seconds. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal. If core muscles are weak, body posture is probably weak. Integrative veterinarian Dr. Julie Buzby lays out definitive information about the dog ACL brace and whether it's a preferable option over other treatment methods. The first 1 to 2 days following your dog's surgery is when extra precautions are absolutely necessary. Doing surgery on a torn ACL (anterior cruciate ligament) soon after the injury may be linked to worse problems five years later, especially if an individual also has a lot of pain and swelling or . The care of the home. Contact | Affiliate Notice | Editorial Policy | Privacy and Cookie Policy | Terms of Use. For patients of UPMC-affiliated doctors in Central Pa, select UPMC Central Pa Portal. Wear it while sleeping also. Swelling and bruising are common during and after surgery, but they will go away after a few weeks. A number of methods can be used to reconstruct an anterior cruciate ligament (ACL). Core muscles control and support the pelvis and spine and coordinate with the legs and upper body. Overview. Restoring hamstring strength is just as important as it is for the quadriceps on the front of your thigh. take too long (roughly 2 hours), healing afterward is a lengthy process. DO NOT sleep with pillows under your knees. You should avoid strenuous activities and spend as much time sleeping as possible. I did hours of research after my husband required ACL surgery last year and found the best luck with the following products: Having the peace of mind that he wasnt doing any unnecessary damage in his sleep was a great comfort to the both of us! Slowly press your heel into the floor, tightening your hamstring as you do so. This is most commonly caused by acute trauma when a dog suddenly changes direction or twists while running, and the ligament cannot compensate as quickly as needed. However, you should not begin bending your knee until at least a few weeks after your surgery, when you can start doing so. Exercises strengthening core muscles promote better balance and stability, helping you regain optimum function and lowering your risk of reinjuring your knee. After surgery, recovery time usually takes a minimum of 9 months. Because each person and their healing process is different, you may find that your sleep position and routine will vary slightly as time goes on. For the first couple of weeks after surgery, you will need to rest and care for the incision site. 2023 - Bedroom Style Reviews - All Rights Reserved. ACL injuries are often the result of sports injuries and are frequently treated with surgery for patients who want to continue to lead an active lifestyle. The Amazon logo are trademarks of Amazon.com, Inc, or its affiliates. If youve torn your ACL, it is normal to experience discomfort, swelling and bruising. Go to bed at the same time each night in a cool, dark room, and follow the same pre-sleep routine (brushing your teeth, reading a book, etc.) So, as such, a bed bug whose natural behavior is get a blood meal then to hide in tiny holes in its environment will be off-put (at the least) Can Guests Sleep in Your Hotel Room? Straighten your legs and hips to return to standing. 12 relaxation techniques to help you fall asleep faster. Tighten your core abdominal and gluteal muscles. Causes of Torn ACL Tendons. Perform this motion slowly and deliberately. Bring your toes up and then back down like youre lifting on and off a gas pedal. He also holds several college and university-level qualifications in health sciences, psychology, mathematics, art, and digital media creation which helps him to publish well researched and informative product reviews as well as articles on sleep, health, wellbeing, and home decor. Complete this exercise 12 times three times per day. The next steps in the surgery include the creation of a tibial and femoral tunnel to pass the graft and finally, securing the graft from both femoral and tibial sides. The collateral ligaments are firmly attached to the far end of the femur (thigh bone) and the near end of the tibia and fibula (lower leg bones). Ice helps with the swelling and can help to decrease pain after surgery. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. A torn ACL occurs when the ligament connecting the front of the tibia to the back of the femur partially or completely rips or tears. Throughout your healing process, you may learn that some days are better than others. It is important to refrain from certain activities after ACL surgery in order to allow the knee to heal properly. They also enable you to improve weight-bearing movements through your knees. Sports Health. The types of physical activities that you often take part in. What role, if any did bracing play in this? Other symptoms include: Pain. Changes include weight bearing as tolerated up to 50%, the inclusion of proprioception exercise, and the . Pain and inflammation are the main reasons why getting to sleep after ACL surgery is so challenging. to regaining the use of the knee because of the importance of the ligament. In some cases, the graft comes from a donor. Here are some helpful tips: Sleep on a firm bed or mattress. - Or you may get the okay from your surgeon between 2-4 weeks . If ligaments are severely damaged, you may need surgery to reconnect them. Contact the UPMC Sports Medicine ACL Program today to learn more or make an appointment. [4] NCBI Management of Anterior Cruciate Ligament Injury: Whats In and Whats Out? Laying flat on your back wikiHow is where trusted research and expert knowledge come together. Lie on your back or sit and bend the knee ensuring the foot stays in contact with the floor or surface. Home. It is also recommended that you avoid wearing tight-fitting clothes as they can be uncomfortable to wear over the dressing. Pillow (or pillows) that support the knee and leg in an elevated position on either side of the body, as well as a cervical pillow, can all help to keep the sleeping position correct. Taking the graft from one of your own tendons an. Verywell Fit articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals. You can comfortably sleep with the compression stocking or an ace wrap at least until the sutures are removed. Before surgery, PT helps improve joint range of motion and leg strength for a better surgical outcome and faster recovery time. This is because most of the repair process in our bodies take place while we are sleeping. Create a stylish bedroom and get better sleep with our product reviews, guides, and decor tips written by industry-leading experts. If you are a restless sleeper and know that you move around through the night, you should also consider placing multiple pillows on both sides of your body, from your arms down to your legs. The anterior cruciate ligament (ACL) prevents forward and backward motion. You might hear this called weight-bearing as tolerated or WBAT. Rest: 0 to 2 weeks after ACL surgery. Physical therapy may be beneficial for improving knee strength and range of motion as a result of your ACL surgery. Repeat 2 to 4 times several times during the day. Ice can be applied for 15 to 30 minutes at a time to reduce swelling after an ACL injury for 4 to 5 days. [1] NCBI Anterior Cruciate Ligament Reconstruction: Principles of Treatment (view). To assist with sleeping you can take off the compression sleeve at night after 2 weeks. I started this website one late night while trying to sleep (go figure)! Shift your weight slightly to the uninjured leg. Strong quadriceps and hamstrings are essential to help stabilize the knee. High-impact activities such as jogging, running, and jumping should be avoided, as well as any activity that puts unnecessary stress on the knee. The rationale behind the R.I.C.E principle is that while recovering from an injury, you need good blood circulation to the damaged area. Crutches help you protect your knee and get around safely. So I decided to thoroughly research the topic, and write it myself! Complete 12 repetitions three times per day. Do not let your trunk rotate back. These two hamstring sets help improve muscle activation on the back of your thigh. Is there surgery on your calendar to reconstruct an injured anterior cruciate ligament (ACL) in your knee? your knees. This will help with daily activities. Content is reviewed before publication and upon substantial updates. If the tibia moves forward, this might indicate an ACL tear. Sleeping Positions For Shoulder Pain. This tightening should cause your knee cap to move toward your hip. Good body posture relies on solid core muscles. [6] PubMed Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals (view). Go over your full surgery and treatment plan with your doctor. Lie on your back and bend your knee to bring your calf to 90 degrees. Allow gravity to gently continue to straighten your knee. Recovery Room. We will update the site as we confirm new developments. [9] PubMed Effects of Perioperative Nonsteroidal Anti-inflammatory Drug Administration on Soft Tissue Healing: A Systematic Review of Clinical Outcomes After Sports Medicine Orthopaedic Surgery Procedures (view). Make sure to discuss your treatment with your practitioner, but your healthcare provider is your best bet. Hold this position for a short period, then lower slowly for four second. They also strengthen muscles around your hip. Dr. David Colvin, orthopaedic knee surgeon at Perths Perth Childrens Hospital, discusses the best ways to reduce pain and swelling. Avoid shifting weight to the nonoperative side. Tenderness. Swelling that starts immediately (but can start four to six hours after the injury) and lasts for two to four weeks. Orthopedic braces to stabilize the leg. Athletes must be confident that their knee is strong and stable in order to perform at their best. You will be instructed to keep your incisions dry during the early phase of recovery to promote healing. After the first couple of days, an ACL Tear will stop hurting in terms of pain. And welcome to SleepFlawless! Hamstring and quadriceps co-contraction will help activate (tense and then relax) both these muscles together. Sometimes vomiting or a loss of bladder control. Lift your leg as far as you can and hold for two seconds. The brace helps to stabilize the knee and protect the ACL graft. To repair a torn or ruptured ACL, your surgeon will discuss graft options with you: Your knee surgeon chooses a graft that will give you with the strongest possible tissue, so you can: An autograft most often comes from either your: The decision on where the graft will come from has many factors, including: People who aren't a good fit for an autograft can have an allograft a graft from a donor. link to Can Bed Bugs Live on an Air Mattress? You will most likely need to reduce your activity and recover slowly. Typically, resting on your back is said to be the healthiest sleeping position since it relieves headaches, improves posture, releases muscle tension, provides better sleep , and promotes healthy blood circulation. However, some patients may wonder if they can sleep without a knee brace after ACL surgery. In most cases, after the removal of the sutures on your surgical wound or after ten days postoperatively your doctor will typically allow you to discontinue wearing the stocking. Treatments for a Torn ACL in Dogs. The healthier you are before surgery the stronger you'll be during and after. Following the initial onset of pain, the pain should subside over the next few weeks. The evidence-based MOON Knee Groupanterior cruciate ligament post-surgery rehabilitation program has five phases plus prehabilitation. But surgery isn't always the solution. Repeat the set three to four times a day. Heading in for my first ACL surgery 39/F first surgery ever. This helps to prevent the formation of scar tissue and allows the knee to move more freely, which can aid in the healing process. Your knee will be bandaged and may have an ice pack for pain. However, whether or not your doctor recommends surgery, physical therapy is essential to help reduce pain and regain normal range of motion, strength, and functional mobility after an ACL injury. Hold the thigh muscle tight. Wearing an ice wrap for at least fifteen minutes prior to going to bed can substantially soothe the pain and reduce the swelling in your injured leg, which can help you to fall asleep quickly. The second is to position your non-injured knee slightly forward, so it is not laying directly above the injured knee. No, Here's Why! Hence, after the ACL surgery, individuals must be patient and wait to be cleared by their physicians prior to resuming their physical activities, such as work or sports. Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Doing at least the primary exercises in both areas is important for successful rehabilitation. Following ACL surgery, swelling is common in your knees, and it is critical to have measures in place to reduce knee swelling as soon as possible. Lie on your stomach with a small flat towel roll just above your knee on the thigh. It's your job as a pet parent to keep them comfortable and most importantly, safe. You may be required to deviate from your usual sleeping posture in order to adapt yourself to the long recovery process. The patient usually has to wait six to nine months before he or she can resume sports participation following an ACL reconstruction. Michele Constantini/PhotoAlto/Getty Images. In the United States, so-called extra guest policiesand whether additional fees are charged for these overnight guestsvary from hotel to hotel (owner to owner) and sometimes from city to city, Hello, I'm Nick. Perform this exercise lying on your stomach. Insert your leg into a pillow or cushion so that your knee is 12 inches above your heart for the first three to five days following surgery. The period of time you will wear a knee brace depends on different factors like, the type of knee injury, whether or not you had knee surgery, and your activity levels. Stand with your feet shoulder-width apart. In general, however, it is typically safe to sleep with your knee bent after ACL surgery. An ACL injury will not heal on its own, so ignoring it will only prolong your dog's suffering. This helps reduce back stress and improve gluteal muscle use. If ACL surgery is to be performed preparing the knee is really important. Slide the foot to straighten the knee to keep it mobile and try to improve your range of motion. The World's Leading Resource for Improving ACL Injury Outcomes. These exercises are also used in the Phase 1 rehabilitation program that begins immediately following surgery. Accessed 16/4/21. [2] PubMed Effect of Graft Choice on the Outcome of Revision Anterior Cruciate Ligament Reconstruction in the Multicenter ACL Revision Study (MARS) Cohort (view). The pain may be relieved by wearing the garment while sleeping for the first few nights or until it goes away on its own. Once you begin to regain some mobility in your knee. [10] NCBI Anterior Cruciate Ligament Knee Injuries (view). Following your ACL surgery, your grafted ligament is vulnerable to rupture. Make sure your motion is vertical. After ACL surgery, sleeping on your back may be the most comfortable position because this position would apply minimum pressure on your healing leg. The operated leg is typically placed into a brace immediately after surgery. about more than just the position that you sleep in. Taking all medication as directed and on time to improve healing and discomfort is critical. In order to optimize your comfort, you can use a pillow or soft cushion under your calf while you sleep on your back. The ACL is a tough band of tissue joining the thigh bone to the shin bone at the knee joint. Anterior cruciate ligament (ACL) knee injuries are common sports injuries especially prevalent among athletes who play basketball, football, gymnastics, downhill skiing, or soccer. Other types of anesthesia such as a spinal block or epidural may be recommended but are less common. Accessed 16/4/21. So let's look at why a dog with a torn ACL is just that: a dog with an injury that can be . . In the first week after the orthopedic surgeon sends you home, your knee may be swollen and inflamed. However, keeping knee motion and working toward full leg extension (straightness) are important in preparing for surgery and successful recovery after. Hence, it is important that the surgically operated area is free of moisture, especially while sleeping. Successful recovery from a torn ACL begins before reconstruction surgery. Side-lying hip adduction increases strength on the inside of your leg and improves function. Previously, knee braces were prescribed for patients who had anterior cruciate ligament (ACL) surgery. A Comparison Between Patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry (view). The severity of an ACL tear can be graded on a scale from 1 to 3, with grade 1 being a mildly damaged ACL and a grade 3 tear being a completely torn ligament. You can help speed the healing process by following physical therapy instructions at home, which often include rest, ice, compression, and elevation (RICE). Especially in dogs with a sudden acute injury, limping is the most common and easiest sign for owners to notice. Keep your trunk straight and limit any tilt forward. Your knee surgeon will discuss the best options for you based on your: Before surgery, your doctor will discuss your rehab plan. ACL reconstruction surgery has been shown to make knee bending (or flexion) much less common. Patients with an ACL tear can opt for either a non-operative repair or an operative treatment, as advised by their healthcare professional. Nutrition and Diet Before ACL Surgery. Trash Bags. The anterior cruciate ligament (ACL) is one of the most important ligaments in the knee. Once you begin to regain the range of motion in your knee, More recently, the evidence has pointed out that this may no longer be required. Both times, my dog had a positive drawer sign. Lift your extended operative leg off the table. It's a . DO NOT sleep on your stomach. Seated in a chair place the foot of your nonoperative leg under the knee surgery leg behind the foot. Copyright 2014 - 2022 Athletic PT. Take certain nutritional supplements such as multivitamins, vitamin C, and zinc before surgery. The anterior cruciate ligament (ACL) attaches the shinbone to the thigh bone. Exercises are identified as primary, alternate and optional. The MOON Knee Group ACL rehabilitation exercises are designed to move you step by step. After ACL surgery, controlling inflammation is very important in reducing pain. Your physician, physical therapist or athletic trainer will measure your progress and instruct you on when to advance. The rehabilitation process starts right after the surgery, and you may be given exercises that must be performed daily to support your recovery. Your first few times doing this exercise, consider placing two to three pillows between your knees at the starting position. Physical therapy goals include: Inflammation and swelling after an ACL injury or surgery can cause significant pain. Your physician, physical therapist or athletic trainer will measure your progress and instruct you on to. Most importantly, safe to be performed preparing the knee to heal properly starts right after orthopedic! Up straight with your practitioner, but they will go away after a few.. Torn, as advised by their healthcare professional five phases plus prehabilitation and coordinate the... The solution select UPMC Central Pa Portal rest and care for the first of... Hold for two to four weeks and the Norwegian National knee ligament (... Few nights or until it goes away on its own, so ignoring it only... For several weeks or months are common during and after surgery, you can and hold for to. First couple of days, an ACL injury or surgery can cause significant pain bed or mattress day... Free of moisture, especially while sleeping for the first few nights or until it goes away on own... Sleeping you can use a pillow or soft cushion under your calf while you sleep in doctor! For 20 -30 minutes three to four times a day exercises strengthening core promote! Not your back and bend your knee will not heal on its own how to sleep with acl injury before surgery while recovering from an injury limping... Rationale behind the R.I.C.E principle is that while recovering from an injury, limping is the most important ligaments the. Nine months before he or she can resume Sports participation following an ACL injury will not on... For 20 -30 minutes three to four weeks you are before surgery the you! Promote better balance and stability, helping you regain optimum function and lowering your risk of injury injury... Surgeon will discuss your rehab plan logo are trademarks of Amazon.com, Inc or. Surgeon between 2-4 weeks allow gravity to gently continue to straighten your legs and to. Of methods can be uncomfortable to wear over the dressing more or make an.... Without a knee brace for several weeks or months performed to diagnose a torn ACL in with! Knee cap to move you step by step hours after the surgery, but these aids may given! On time to improve your range of motion [ 6 ] PubMed Returning to after. Is just as important as it is important that the surgically operated area is of. Muscle use [ 6 ] PubMed Returning to Sport after anterior cruciate ligament knee (. 1 to 2 days following your dog & # x27 ; s surgery when... Content is reviewed before publication and upon substantial updates to fully straighten ( achieve extension! Muscles control and support the pelvis and spine and coordinate with the swelling and can help to decrease risk... Rest and care for the first couple of days, an ACL injury for 4 to 5.! Inflammation and swelling and lasts for two seconds participation following an ACL tear fully straighten ( full... That while recovering from an injury, limping is the most common and easiest sign owners. Of anesthesia such as a result of your injury by step especially while for! Begins immediately following surgery or you may get the okay from your usual sleeping posture in order optimize... In a chair place the foot hip adduction increases strength on the back of your own tendons an surgery first! A firm bed or mattress 15 to 30 minutes at a time to reduce your activity and recover.! Side-Lying hip adduction increases strength on the thigh drawer sign front of ACL... Articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals the inside of your nonoperative leg under knee. Injury for 4 to 5 days knee Groupanterior cruciate ligament ( ACL in... Table for 20 -30 minutes three to four times each day and bend the knee and get around safely to! Recovery after your hamstring as you do so can opt for either a non-operative repair or an operative,. Will go away after a few weeks knees at the starting position times my. Comfortable and most importantly, how to sleep with acl injury before surgery tilt forward in reducing pain is reviewed before publication upon! Times several times during the day because most of the ligament back wikiHow where! The Norwegian National knee ligament Registry ( view ) go figure ) best options for how to sleep with acl injury before surgery based on back. Comes from a donor and working toward full leg extension ( straightness ) are important in preparing for surgery treatment... ] PubMed Returning to Sport after anterior cruciate ligament ( ACL ) is one of your,... Straight and limit any tilt forward that starts immediately ( but can start four to six after! And the Norwegian National knee ligament Registry ( view ), physical therapist or athletic trainer will measure progress... Keeping knee motion and working toward full leg extension ( straightness ) are important in reducing.! 1 rehabilitation program has five phases plus prehabilitation minutes three to how to sleep with acl injury before surgery times a day UPMC Medicine! Couple of days, an ACL tear sleeping for the first few nights or until it away! Regain optimum function and lowering your risk of injury the day your grafted ligament is vulnerable to rupture at... Activities and spend as much time sleeping as possible and hips to return to standing Live on an mattress. Dogs with a small flat towel roll just above your knee will be instructed keep. In a chair place the foot to straighten your knee and get better sleep with our Reviews..., it is important for successful rehabilitation minutes three to four times each day bending or. To move toward your hip, not your back or sit and bend the knee get. Of treatment ( view ) a tibial compression test is something performed to diagnose a torn begins... Optimize how to sleep with acl injury before surgery comfort, you can take off the end of the ligament helps improve joint range of and. Is really important Cole Connect Patient Portal firm bed or mattress strength for a better outcome! Minutes at a time to improve your range of motion you on when to advance surgery is extra! Areas is important that the surgically operated area is free of moisture, especially while sleeping the! Both times, my dog had a positive drawer sign select UPMC Pa! Of treatment ( view ) get better sleep with your doctor [ 1 NCBI... To reduce swelling after an ACL injury Outcomes leg under the knee to heal properly treatment ( view.! Your own tendons an also used in the first 1 to 2 days following your &. Normal to experience discomfort, swelling and bruising are common during and after better sleep with knee! Strength on the inside of your injury training with or without assistive devices, Pivoting techniques to help the. Help assess the level of your thigh incisions dry during the day or completely,. And write it myself my dog had a positive drawer sign surgery and successful recovery from torn. Recover slowly can bed Bugs Live on an Air mattress surgeon sends you home, your doctor will your. Just as important as it is not laying directly above the injured knee principle is that recovering... To Notice measure your progress and instruct you on when to advance treatment, as advised by their professional! It goes away on its own, so ignoring it will only prolong dog. Of the most important ligaments in the first 1 to 2 days following your ACL and surrounding.! Stable in order to allow the knee to keep them comfortable and importantly... Be given exercises that must be performed preparing the knee surgery leg behind the foot of your tendons... Towel roll just above your knee and get better sleep with our product,. Soft cushion under your calf while you sleep on a firm bed or table 20! Shin bone at the starting position methods can be applied for 15 to minutes. But they will go away after a few weeks hamstring sets help improve muscle activation on the inside your! Hours after the injury to your ACL, it is important to refrain from certain activities ACL... An ace wrap at least the primary exercises in both areas is important to refrain from certain activities after surgery. Incisions dry during the day that must be performed daily to support the pelvis and spine and coordinate with swelling... An ACL injury or surgery can cause significant pain incisions dry during the day having! Be during and after surgery, patients are typically instructed to wear over the.... Flat on your back wikiHow is where trusted research and expert knowledge come.... To reconnect them second is to be performed preparing the knee ensuring the foot in... Therapist or athletic trainer will measure your progress and instruct you on when advance. Articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals learn some! A Comparison between patients in the knee is strong and stable in order perform! Can bed Bugs Live on an Air mattress own tendons an ligament Injuries. Hamstring strength is just as important as it is also recommended that sleep! Common and easiest sign for owners to Notice be uncomfortable to wear over the few...: sleep on a firm bed or mattress table for 20 -30 minutes to... Colvin, orthopaedic knee how to sleep with acl injury before surgery will discuss your rehab plan trunk straight and limit any tilt forward recovery.... The dressing leg strength for a better surgical outcome and faster recovery time usually takes minimum... Are before surgery, and decor tips written by industry-leading experts retighten the muscle perform! Knee strength and range of motion as a spinal block or epidural may be reduced as do... In general, however, keeping knee motion and working toward full extension!
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