LearnMuscles.com Founder Dr. Joe Muscolino on Technology and Posture
Toree: Hey there, I’m Toree McGee. This is The Rapid Recovery Report, sponsored by ROMTech, the modern technology of rehabilitation. You may have noticed that we’ve formatted our show to be a little bit different now, and you will see us only once a month, at the very last Thursday of the month. We’re going to be bringing on surgeons and folks in the ROMTech world like you’ve seen, but we’re adding in a variety of experts in sports and sports med, and movement, and kinesiology, and all things health.
Expert Chiropractic Physician, Dr. Joe Muscolino
This month, we actually have a global author, lecturer, and manual therapy educator. He’s got over 35 years of experience in the movement therapy and kinesiology world, Dr. Joe Muscolino. He’s a licensed soft-tissue-oriented chiropractic physician, who’s owned and operated his private practice since 1985. He’s authored to multiple textbooks covering body mechanics, kinesiology, as well as manual and movement therapy technics, which is used in a core curriculum courses in education institutions across the world.
Dr. Muscolino is an approved provider by the National Certification Board for Therapeutic Massage Body Work for continuing education credit. And as founder of Learnmuscles.com – that’s my dog Winnie back there – Dr. Muscolino actually offers a variety of workshops and courses for manual therapists and movement professionals. So, professionals in this industry can check out his video streaming subscription courses directly on the website Learnmuscles.com. To say he’s an expert is an understatement.
So, welcome to the show, Dr. Muscolino. We’re really really excited to have you here today.
Dr. Muscolino: Very much, Toree. It’s my honor and pleasure.
Toree: Great. So, you’re one of our very first kinesiologists actually. I think you are the first on our show. So, our listeners have a little bit better understanding, can you describe the differences between kinesiology, physical therapy, and chiropractic?
Dr. Muscolino: Sure. So, first, kinesiology is not a profession, like chiropractic is a profession, physical therapy, or in the rest of the world, English-speaking world, physical therapy is a profession. Kinesiology means an application of study or an understanding of study. “Kine” is Greek for movement, “ology” means understanding of, or knowledge of, or study of. So, kinesiology is the study of movement, and the context is movement of the human body, and that would mean that it’s basically what is usually called the musculoskeletal system, because muscles contract, create forces that move bones at joints. Therefore, musculoskeletal, nowadays we have to acknowledge fascia, so you could save myofascial skeletal system. And then we have to acknowledge the nervous system’s coordination control, so it’s the neuro-myofascial skeletal system.
Lots of long sounding words, but it means the study of movement, which means that really any manual therapist, physician, any movement therapist physician practitioner would be, in effect, in some way, a kinesiologist.
And I should add one more thing. There’s a proprietary technique out there called applied kinesiology, abbreviated AK, and that is probably because it’s marketed as a technique, is probably more well-known as the terms a lot of people hear, oh, you’re right on kinesiology, oh you do kinesiology, and they immediately assume that the person is doing applied kinesiology technique, which is a way of doing muscle testing for diagnosis assessment, so that’s something else entirely.
Toree: Okay. That was a lot of big words, made you sound really smart.
Dr. Muscolino: Yeah, you put something in Latin, and it automatically sounds better.
Toree: So, then a lot of physical therapists, chiropractors, and pretty much everybody in the medical field has studied kinesiology at some point, right?
Dr. Muscolino: So, I’ll go to the term musculoskeletal, it’s easier from the longer ones. Anyone that studies anatomy and physiology would be studying both somatic or musculoskeletal anatomy and physiology, which means, again, muscles, bones, joints, and would also study visceral anatomy and physiology, which means internal visceral organs, like heart, lungs, gallbladder, kidney, intestines, kind of thing. So, everyone would have studied it if they’re in the health field.
Toree: Got it, okay. So, over the last 30 years, you’ve written books, and you teach several different master classes online, you participate in global lectures in the movement therapy space. So, what inspired you to make this a lifelong career?
Dr. Muscolino: Oh, goodness. I mean, if I really would go back, growing up, my father is a role model, and three uncles that were role models that all worked. My father was an engineer, and two of my three uncles were chiropractic physicians. And it was always something I kind of lean toward either – I mean, to be very honest, it was either going to be, when I was a kid, an engineer or a chiropractor. And the day I got into advanced algebra and trig, and I didn’t like trigonometry, I said, “Well, I don’t like math, so I’m not going to be an engineer.” So, I said, “Okay, well, default, I’ll become a chiropractor.” And that’s the direction I went, but I do apply a very mechanical biomechanical model based on the upbringing with my father’s influence.
Toree: Okay. Well, I don’t like math either, so that’s why I’m not an engineer.
Dr. Muscolino: Okay, there we go. Yes, I do like math, just not trigonometry, so I hope we don’t offend a lot people writing, and saying, wait, trig is wonderful.
Toree: Oh, that’s funny. Well, I mean, I just don’t like math in general, so if they have any complaints, they can just tell me that I’m wrong.
Dr. Muscolino: Okay, there we go.
Today’s Technology Affecting Posture
Toree: Put it all on me. Now, when we spoke with you before the show, you mentioned the evolution of technology is changing people’s postures, how they are using muscles in a way that our bodies aren’t necessarily built for. I mean, like using our fingers to swipe around smartphone all day. I mean, I knew that my chiropractor has told me that my neck is like I’ve got like the phone neck thing, where there’s that natural curve that’s kind of gone now. I mean, what’s your take on all of this kind of thing for those of us that sit at the computer for long periods, or on their phones?
Dr. Muscolino: I’m not going to say that technology, digital technology necessarily is the evil culprit, but it has accelerated what is a tendency that’s been going on for a very long time. So, first, you mentioned swiping around with thumbs, so right there, there’s something that used to be called blackberry thumb, now it’s called texting thumb. I mean, just using our thumb. There’s something called an overuse disorder, right? And there was a great author in the world of manual movement therapy named Leon Chaitow, who wrote countless books, and I love his saying. He would say, “Use, overuse, misuse, abuse.”
So, it’s not that it’s something inherently unhealthy, but if you do it a thousand times a day, instead of 12 times, then you’re going to break down tissues that are involved, so that’s the possibility for thumbs. And I will argue that I tend to look at both sides of the coin. One could argue that, by doing it, we’re making the musculature stronger, and we’re putting more physical stress in a good way into the bones, and by Wolff’s Law, makes them thicker and all that, but there’s still going to be some simple point at which tissues could not bear any more physical stress.
So, that’s just dispensing with the thumb for a moment, and we can talk about angles at the wrist for carpal tunnel, and other things, but if we jump to what you mentioned about the neck, there are supposed to be natural curves to the adult human spine, and the neck, the cervical spine. The neck is supposed to have what’s called a lordotic curve, which is a curve of extension which brings the center of weight of our head back over our trunk. And if we’re constantly, instead of being backward in extension this way, in a good fashion – and I should also add, some people use the term lordotic or lordosis to mean unhealthy, so they would say what I would call hyper, too much, lordosis or lordotic. I use the term as a healthy lordotic curve, healthy kyphotic curve, so we need the extension.
Well, if we’re constantly looking at something down in front of us, like this, and we’re down this way, we are reversing the curve of the spine. We are stretching out the tissues in back, the fascial tissues, the ligaments, joint capsules in back, and they get stretched out and weakened. We are allowing the ones in front to adapt and become shorter, and in effect, tighter. We are putting the center of weight of our head. It’s no longer over our trunk. It’s now imbalanced, precariously over thin air, and it should fall all the way until your chin hits your chest, theoretically. But if it doesn’t, it means muscles in back have to isometrically, constantly contract to hold you in that otherwise imbalanced posture, and that is making the muscles contract, contract, and contract, and they get tired from contraction, they get tight, they get painful.
When muscles contract, they close off venous return of blood, which then can cause a buildup of waste products of metabolism. And if they get too tight, they close off arterial supply of blood, which would normally bring in nutrients, and that can then lead to creation of muscle knots, myofascial trigger points. Then it just becomes this vicious cycle.
We have the same problem when we were reading a magazine or looking at a piece of paper, or writing on a desk, because I remember back when I came out in 1985, telling my patients they should go and buy the architecture engineering desk that’s angled upward, so you weren’t going down, you were bringing what you’re looking at up to you. The problem today is that we are simply multiplying many times folds how much time we spend in that forward-inclined position.
Toree: Sure. Now, I mean, once you kind of get into that, where you’re realizing I guess how much time you’re spending in not-so-optimum positions, is there a way to reverse like some of the damage that you’ve done?
Dr. Muscolino: So, I guess the first thing I’d say is, first, can we first stop doing further damage, and then that would be, can we find a way to have a posture, a position where we can accomplish what our tasks are without causing further unhealthy physical stress. And just to go with that idea of these IT digital devices, I would say that desktop computers can theoretically be healthier than before, right now, I’m working with phone, looking at you for this broadcast, but my desktop computer is there.
Now, if I were working with my desktop screen there, I can set my keyboard to be the appropriate height for that, which is to let your arms, in lay terms upper arms, hang vertically, and then you simply bend at your elbow joint to meet your keyboard, and that would be, at approximately, a 90-degree angle, and that’s pretty easy for elbow joints to do, and now you’re not elevating your shoulder girdles. You don’t want to have your keyboard way out in front, where you’re isometrically constant contracting the arm, the anterior deltoid, other flexor muscles in front, so you can let your upper extremities be in a relaxed posture here.
And then center of your screen should be about at the level of your eyes, and it shouldn’t be off to one side or off to the other. It should be straight in front of you. And if you have that, then you can theoretically maintain a normal healthy posture for all of your spinal curves, for your shoulder girdles, for your upper extremity.
I’m only 5’6”. I actually also have a little cushion under my feet, because with this desk that was in my apartment, and we bought years ago, at this height, I found that for me to get my chair to the right height, my feet would be just touching the floor, and it would press against my back of my thighs, my hamstrings, and cut off blood supply, and make my hamstrings tight, so I bought a cushion for my feet to be on. So, I’m kind of, ergonomically, setting up all of my body to be in a neutral good posture, and good posture is simply defined as one that causes the least undue physical stress on your muscles, your bones, your ligaments, your joints, your tendons, blah, blah, blah. So, that’s the first thing, is to figure out that.
The problem I’ll say is that the younger generations of which compared to me, you definitely fall into, tend to go to laptops and phones and tablets. And they, by definition, marry the keyboard to the screen at a certain point. If you want the screen to be the right height up, the keyboard’s to high. If you want the keyboard to be at the right height down, the screen’s too low. It’s almost impossible to make them perfect.
If you’re just reading and looking, sure, you can just set it on the stand of some sort. If I were to pretend, that is my phone there, so I can’t really show you with that. If I were to pretend with – I don’t know. This is an old-school set of flashcards. If I were to pretend that this is my phone, again, I don’t want to be down like this, so I need whatever I’m looking at to be vertical, not horizontal, and to be approximately at eye level. But if I hold it up here, the very act of holding my arm in the air, you could even just take your other hand and put it up on top of your base of your neck here, top of your shoulder, will make when the arm flexes forward, the shoulder girdle has to do something called upward rotate, and that makes your upper trapezius isometrically constantly contract. Then that goes all the way up on your head. And if you make it tight all the time, it will get too tight, and then you’ll even get tension on your scalp, and you’ll have tension headaches, so that doesn’t work. So, you need to find a way that your upper extremities can be relaxed.
At a desk, I could simply plant my elbows down. Hopefully, that noise was heard. And then I can simply just work my biceps muscle, elbow joint flexors to be here. If I don’t have that surface, then I could take my left upper extremity, and put it across. Here, I’ll do it higher. You see there. And then, take my right arm, upper arm, and put it there, and rest it there. And now, I can be pretty much at eye level. I got one finger thumb to move around. If I need two, I can try, and do this.
These are all workaround ways to try and make it work. The point is, you take a step back, and say, “Is my head-neck in a good posture, are my arms relatively relaxed, am I not rounded forward?” If you can kind of self-diagnose, self-assess, then there really isn’t going to be an issue. I know I’m talking a lot, but I’m going to have one more piece.
Toree: Yeah, no, go ahead.
Dr. Muscolino: Because very often, in a workshop, I’ll teach by giving an example. So, if I put this here, and I say, here is like a little tablet here, like some post-it notes. If I said, “Toree, your job is to come over here, and just make sure that this set of post-its stays on this box here,” and I said that’s your job to keep it there. You’d say, “Well, that’s no trouble, because I don’t need to do anything.” It’s balanced in that posture.
So then, I say, “Okay, well, how about if we’re like this?” You see it’s hanging over, but it’s still not a problem, because the center of weight of the post-it is still over the object below. how about there? It’s still not a problem. How about there? Well, now, it wants to fall? So now, if you want to keep it, you have to exert effort, muscular effort by holding it there. And if I said I want you to do that, you come over and to that, and say, “This isn’t so hard, I can do that.” And then I say fine, please do it 60 seconds a minute, 60 minutes an hour, 16 hours a day, seven days a week for the next 40 years, which is practically what people do when you look at sitting at desks and tables to eat, and taking care of your child, and whatever you’re doing, and then it becomes use, overuse, misuse, abuse.
So, a lot of people, when they say, “Well, it doesn’t hurt me,” sure, it doesn’t hurt now, but by the time it does, it’s going to be much harder to remedy, and you probably cannot remedy it 100%.
Toree: Sure. That was great. I’m glad that you added that last piece in, because that was a great example. And I mean, really, it kind of is like self-policing, because even as we were having that conversation, it made me assess my posture as I’m sitting here, and those listening to that probably the same thing. So, keeping a little reminder, a post-it, wherever your work space is, is probably ideal for you as well, right?
Dr. Muscolino: You would think the fellow who runs my website with me for all the streaming video classes and anatomy phys and all that, when I do FaceTime or WhatsApp meetings with him, once in a while, you hear this buzz sound, because he works at a computer, that is his life all day, and he sets a reminder every 15 or 20 minutes to make a little sound, so he stops for a moment, and he kind of straightens up, or gets up, and walks around, gets a glass of water, or what it is. Even little things like that, sometimes those little things can make all the difference just to kind of catch us, as we get more and more and more and more consumed in our work, and we start to forget.
Toree: Yeah, well, that’s smart. Maybe I’ll do that, because I’m in front of my computer all day. Maybe I’ll set little alerts for me to just shake it off every once in a while. I mean, do you have any little desk exercises that you might recommend for those of us that are stuck at the desk all day, to keep our necks and shoulders in tiptop shape?
Dr. Muscolino’s Posture Tips
Dr. Muscolino: Yes, I can. I mean, I can reason for all the different things we do here. I’ll kind of say this, there’s a condition called upper-crossed syndrome. It’s a postural dysfunction distortion pattern named by a fellow named Vladimir Janda from the Czech Republic years ago, and it’s probably the most common postural distortion there is. And it involves not just – because we normally don’t just round with our neck and head forward. We normally round from our upper trunk, upper thoracic spine, and that couples with a protraction or rounding forward of the shoulder girdles, which then couples with a medially and internal rotation of the arms at the glenohumeral shoulder joints. And then the center of weight of head is over thin air, and you get protraction, gliding forward of the head. So, it’s just complex of factors. And I really believe that the most root cause of that is first the thoracic spine.
So, it’s not possible to say, let me get my head back over my trunk, if my thoracic spine is rounded. So, I want to make the point, given we gave the example of head and neck before, the more primal to that is really the trunk, the thoracic spine. So, getting yourself back up, and trying to extend the trunk at the spinal joints, then bringing the shoulder girdle’s back. Then if you do literally stop for a moment, and you’re not typing, then trying to – I don’t know how well this is seen – to turn outward, to laterally rotate, and try and tuck your head and neck back.
Because static postures, even when they’re good ones, to me, are – I don’t know – A, they’re boring. Patients don’t like to do them. And B, they’re just uncomfortable to hold, is to make it more of a dynamic movement pattern stretch, which involves the kind of back away from desk here, is to kind of do shoulder rolls, and especially up and back. I generally recommend 10 in this direction, then 5 in the other, and then 5 going back again. And that with the trunk extending and with the shoulder girdles going back, begins to set the base that you can then start try and get the head and neck back.
Really, it all depends. If you’re trying to overcome 12 hours of bad posture with 6 minutes of good postural exercises, it’s not going to work, which is why I really think the most important thing first is to figure out how to not be doing the damage.
Dr. Muscolino: I very often like the analogy of old-fashioned weight scales. You want to buy a pound of bananas 50 years ago, so you put a pound weight on one side, and the bananas on the other side, and the scale can tip one way or the other. And I very often like to say good musculoskeletal health is really having more good things to weigh you down in the right direction, but also fewer bad things to help you weigh down in the good direction. You need to look at both of those sides of the equation of balance.
Toree: Yeah, so the ergonomics, for sure, and then like kind of the fixing, right? So, the preemptive to make it not worse, and then the actual exercises to kind of get you going, and make it easier to have a better posture later on.
Dr. Muscolino: There’s a pet peeve of mine I just thought of now, because it just came up here. Because when we say erg, erg means work, so ergonomics is the study of the workplace, but we don’t only work. We live, we have our dinner table and our breakfast table, and we do other hobbies we have, and we sleep. And even if someone only sleeps six hours a night, even if it’s only six – and I know some people get fewer hours than that, but we normally think of eight hours as the ideal, and six is the lower end of ideal. Most studies show that anything less than six starts to really affect our health, so let me use six as the baseline.
Six hours a night, 6 out of 24 hours is one fourth of our life. That means when we reach the age of 80, we spent 20 years in bed. If we are sleeping in a bad posture, then that is tremendously deleterious to our musculoskeletal health. And pet peeve of mine is you watch TV shows and watch movies, and you see a scene where whatever, two spouses are talking in bed, or someone goes to lie down in bed, and shut the light off, and they never have the right pillow circumstance, because if they had the right pillow, the pillow would fill in the lordotic curve of the cervical spine, and let the heads go back against the mattress effectively, which means the only way the camera could shoot them would be from the ceiling, which is pretty disorienting and weird. So, to be able to have the camera coming from any horizontal angle, they always throw a load of pillows behind—
Toree: I have pillows back there.
Dr. Muscolino: To me, if a kid grows up watching TV shows and movies, and always sees these large pillows or multiple pillows, they’re going to naturally follow that, because that’s what they see, and mom and dad don’t necessarily know any better. So, right there, if you picture too much pillowage behind your head, what’s it going to do to you? It’s going to do this to you, and we already have that in every other way. So, we need to kind of take a step back, and look at all of the postures that we assume and movement patterns that we assume, and try to say, “Is this helping to attain what would otherwise be a natural neutral posture, where I’m not too forward, I’m not too back?”
Is my shoulder up on one side because I’m putting a bag or a purse there? The bag is empty, it doesn’t matter, just do this, and stay that way for two hours, versus a bag that goes cross body. Here, you don’t have to raise the shoulder to hold it. All these little things that we do affect us so much.
Toree: Absolutely. I mean, I always felt like a weirdo, because I would pull my pillow to kind of be at its largest right at the back of my neck.
Dr. Muscolino: Good girl.
Toree: I feel the older I get, the more I do that now, because I feel a big difference, and that makes complete sense.
Dr. Muscolino: Yes, I mean, it’s great that you’re doing that. It’s fabulous, but it’s unfortunate that, very often, we start to wait until we feel the adverse effect to do something. I mean, with all due respect, it’s like saying I’m going to quit smoking when I get lung cancer.
Our body has a tremendous redundancy resiliency to deal with so much bad posture structure function before it starts to complain, and that’s great, otherwise would be in pain for every little thing, yet it allows us to continue bad habits until way later. And at that point, they’re so entrenched that we have patterns that we don’t want to give them up.
Toree: Yeah, absolutely. I mean, I’ve heard that working with folks that practice kinesiology essentially and posture and all that kind of thing has not only positive health benefits by focusing on the body’s internal and muscular balance, but there could be benefits with like mental and emotional health as well. Do you have any like input on that?
Dr. Muscolino: I’d say I’m starting to venture a little far afield from my specific “expertise,” but every study I have ever read that looks at positive mental health, positive spiritual attitude, etcetera, links that when someone, first, is not in pain. And even the field of yoga, the entire intent of yoga was never to assume these crazy stretching postures, etcetera. Yoga was about achieving an inner peace, an inner clarity, but the reason it went to physical asanas, postures was to try to get rid of physical pain that could then block our ability to go internal, and feel at peace. So, every study I’ve ever seen relates physical health with, in some way, mental health.
So, if we go there by the way, I’m a manual physician, a manual therapist, I am a chiropractor, but I’m extremely soft-tissue oriented, which means I spend much more attention on the muscles, the fascial, the myofascial soft tissues, than on the joint and the adjustment of the joint, etcetera. Not that I don’t believe that’s important, but I believe that bones are passive elements, and they are less important than the active myofascial tissues, the muscles if I simplify.
But even looking at the importance of manual therapy, I think that movement therapy is even more important, because if people truly – so, full disclosure here, my wife has been a Pilates instructor for 26 years. She trained with Romana Kryzanowska, who took over Joe Pilates gym after he died. She’s also a massage therapist. She’s also Feldenkrais practitioner. She was a classical professional ballet dancer when she was younger. So, she inhabits most of the world of movement.
When I recommend to my patient, if they come in with neck pain, shoulder pain, low back pain, whatever it is, if I can get them stable, where they’re either out of pain or mostly out of pain, and their function is there, and the patients who I recommend to do Pilates or yoga or some type of exercise to be active, to get strength of musculature, flexibility of soft tissues, and proper neuromotor posture movement control patterns, I don’t see those patients a lot anymore.
It’s not in my financial interest to do this, but the people who do that, they stay healthy, short of accidents, short of falls and car accidents, short of overuse, etcetera. I really believe that once people can be stable, and I do believe manual therapy is more important, first, before movement therapy generally, to get someone stable if they have an acute condition, it’s fine. Not everyone will agree with that, but I believe that. But once you get them stable, those people that exercise on a regular basis, they tend to stay so healthy.
Introductory Courses at Learnmuscles.com
Toree: I believe that. I do. So, for those in our audience that might be aspiring to do what you do, and go into chiropractic and soft tissue studies and manual work with kinesiology and movement and all of the things, and would want to learn from you specifically, what would you recommend as some great introductory courses at your site Learnmuscles.com?
Dr. Muscolino: Okay. So, first, I would have to state that if anyone is truly going to enter the health field, they probably have to go to a licensed profession, like massage therapy, physical therapy, chiropractic, orthopedics, etcetera, or occupational therapy, in which case they’re going to be getting anatomy and phys, biomechanics, kinesiology, whichever way it’s phrased, in their schooling, but certainly then what I have is extremely thorough methodical, and it comes from critical reasoning point of view.
If someone wants to become a Pilates instructor, a yoga instructor, a fitness trainer, I mean they have to go through certification programs, but they do not get the exhaustive anatomy and physiology that I – I shouldn’t use the adjective exhaustive, right? They do not get the depth that I believe they should have to truly be able to critically think through the mechanism of a client who comes in, who’s presenting with a problem. Almost nobody who’s, I don’t know, 20, 30 years old or older has a virgin body where they go to start working out and doing Pilates or anything, and they’ve had no history of injuries, no history of accidents, no chronic whatever. So, we need to understand these pathologies, these conditions, and that requires truly understanding anatomy.
So, what I have on my website, Learnmuscles.com, is I have a number of what are called master classes. One is Bone and Joint Anatomy Masterclass, which brings us through bones, bony landmarks, joints, functioning of, structured functioning of. Another one is Muscle Anatomy Masterclass that has nearly 1,000 videos in it. It shows everything from simple illustrations with moving arrows to explain, to cadaver videos, to display a person demonstrating the joint actions, the motion patterns, to how to palpate the muscle, how to stretch it. Another one is a pure Kinesiology course. There are a couple of other simple ones. And I have continuing education one for people who are manual therapists and movement professionals, and that right now has over 2,700 videos in it. We have 10 videos a week. I’m very busy with video content creation.
Toree: That’s amazing. So, for those of you out there that want to check out a little bit more about Dr. Muscolino and his website, you can follow him on Facebook at Learn Muscles. He’s on Instagram as Dr. Joe Muscolino. As well as just his website, where you can actually see all of these videos and these courses at www.learnmuscles.com.
Thank you so much, Dr. Muscolino. This was really informative. I’m actually going to implement a lot of your suggestions into my day-to-day here to try to help me and my poor neck.
Dr. Muscolino: Well, you’re very welcome, and thank you for inviting me. This was a lot of fun today.
Toree: Good. I’m so glad. Thanks gain. And thanks, you guys, for watching. Be sure to tune in the last Thursday of every month, we’ll be doing one of these. You can visit us at ROMTech.com, subscribe to our channels. We’re everywhere, Facebook, Instagram, LinkedIn, YouTube. And we’ll see you guys next time.
Thanks again, Dr. Muscolino.
Dr. Muscolino: You’re very welcome. Bye-bye.
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