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If you’ve been diagnosed with a stress fracture, you might feel frustrated and unsure about what it means for your active life. A stress fracture is essentially a small crack in a bone caused by repeated stress or overuse – but despite their tiny size, these injuries can cause big pain and force you to put your activities on hold. They are common in athletes and active people (accounting for roughly 20% of sports injuries), especially runners, dancers, and anyone who suddenly increases their activity level.
In this article, we’ll explain stress fractures in plain language: what they are, why they happen, how they’re treated (including advanced options like shockwave therapy), and what you can do at home to heal. We’ll also share a real patient story to give you hope that with the right care, you can get back on your feet. 
(As always, please consult a qualified healthcare provider for personalized advice.)
It’s not a complete break of the bone, but rather a hairline crack that develops when a bone is subjected to more force than it can handle over time. Unlike an acute fracture (from a sudden injury like a fall), stress fractures build up gradually. Imagine a paperclip that’s bent back and forth repeatedly – eventually it weakens and snaps; in a similar way, bones that undergo repetitive impact (from running, jumping, marching, etc.) can develop microscopic damage. If the activity outpaces the bone’s ability to repair itself, a small crack can form.
Where do stress fractures happen? Most occur in weight-bearing bones of the lower body – commonly in the shin (tibia), bones of the foot (metatarsals), the heel (calcaneus), or the hip. For example, runners often get stress fractures in the tibia or foot. Dancers can develop them in the foot or ankle. Essentially, any bone that gets repeated strain without enough rest is at risk.
Low-risk vs. high-risk stress fractures: Doctors often categorize stress fractures based on how likely they are to heal on their own. Low-risk stress fractures (like many in the shin or foot) usually heal with conservative care (rest and protection). However, even among these, up to one-third of cases may fail to heal with rest alone – meaning the crack doesn’t fully mend and can progress to a more serious break.
High-risk stress fractures are ones in locations prone to poor healing (for example, in the navicular bone of the foot, or the femoral neck in the hip). These have a higher chance of complications like non-union (when the bone doesn’t heal) or complete fracture if not treated properly. High-risk fractures sometimes occur in people with underlying issues like osteoporosis or poor circulation.
In fact, fractures related to osteoporosis are extremely common in older adults – more common than heart attacks, stroke, and breast cancer combined. The key is that ignoring a stress fracture is dangerous: if it doesn’t heal correctly, it can lead to chronic pain or even permanent injury.
Typically, the pain develops gradually. It often starts as a mild ache during or after activity and then gets worse with continued activity. You might notice tenderness to touch at a specific spot on the bone. Swelling or mild bruising can sometimes occur. Unlike muscle soreness, stress fracture pain usually localizes to one area and may even hurt during rest if the injury is severe.
For example, with a stress fracture in the foot, your whole foot might ache, but pressing on the fracture site will produce sharp pain. If you suspect a stress fracture (pain in a bone that worsens with activity and improves with rest), it’s important to get it evaluated. Doctors may order an X-ray or MRI – early on, an X-ray can appear normal, so more sensitive scans like MRI or bone scan are sometimes needed to confirm the diagnosis.
Why do stress fractures happen? The simple answer: overuse and overload. When you increase your activity too quickly or beyond what your bones have adapted to, you risk a stress fracture. Common scenarios include a runner rapidly boosting their mileage or someone starting a new workout program at high intensity. Other contributing factors include:
Training errors: e.g. suddenly adding a lot of distance or intensity without gradual build-up, or not taking enough rest days.
Surface changes: switching from running on a soft track to concrete, or from a treadmill to outdoor pavement can increase impact on bones.
Improper footwear or equipment: Worn-out shoes that no longer absorb shock, or lack of supportive footwear, can put more stress on your bones.
Biomechanical issues: Flat feet or high arches, leg length discrepancies, or poor running form can concentrate stress on specific bones. Muscle weakness or tightness (for example, very tight calf muscles) can also overload certain bones.
Bone health and nutrition: Bones need adequate calcium, vitamin D, and overall nutrition to stay strong. If you have low bone density (osteopenia or osteoporosis) or nutritional deficiencies, you’re more prone to stress fractures. Women with the “female athlete triad” (energy deficiency, menstrual irregularities, and bone density loss) are at particular risk, as are older adults with osteoporosis.
Previous injuries: Past stress fractures or ongoing issues like shin splints can indicate areas of stress that might crack if the strain continues.
In short, a stress fracture is your body’s way of saying “too much, too soon.” The bone gets fatigued and develops a crack as a result. Recognizing these risk factors is important not only for treatment but also for preventing future injuries.
Modern research gives us good news: with the right treatment, stress fractures can heal stronger and sometimes faster than traditional rest-alone methods. Let’s look at what studies show, especially regarding advanced therapies like shockwave:
Rest is essential, but not always sufficient: It’s well established that initially, relative rest (avoiding the offending activity) is crucial for healing a stress fracture. For many people, 6–8 weeks of rest (sometimes in a walking boot or using crutches to offload the bone) allows the bone to heal. However, as noted earlier, up to about 33% of athletes’ stress fractures do not heal with rest alone. In those cases, the injury can worsen or become chronic, which is obviously something we want to avoid. This is why medical researchers have explored additional treatments to stimulate bone healing.
Shockwave therapy shows promising results: Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment where acoustic waves are delivered to the injury site to stimulate healing. You may have heard of shockwave for treating tendon issues or kidney stones, but it’s also used for bone injuries. Research has found that shockwave therapy can kick-start bone repair by stimulating bone-producing cells and improving blood flow in the bone. One review paper noted that shockwave triggers a cascade of biological responses (increased bone turnover, new blood vessel formation, and release of growth factors) that help bone heal. Importantly, multiple studies have reported excellent outcomes using shockwave for stress fractures. For example, a 2015 review of athletes with stress fractures found a high rate of recovery and return to sport when using focused shockwave therapy, with patients achieving pain relief and being able to resume competition. The authors of that study were so encouraged that they suggested shockwave could be considered a first-line treatment in cases that aren’t responding to rest.
Equal to surgery, without the risks: In very stubborn cases, or high-risk stress fractures that won’t heal, surgery (such as inserting pins or screws to stabilize the bone) is sometimes performed. Surgery, of course, comes with risks – infection, anesthesia, long recovery, etc. Fascinatingly, a comprehensive 2010 medical review concluded that shockwave therapy achieved bone healing rates equivalent to surgical treatment for difficult fractures, but with far fewer complications. In other words, patients could avoid surgery yet still heal their fracture by using shockwave, benefiting from lower risk and faster return to normal activities. The same review emphasized that shockwave is safe, well-tolerated, and can be done outpatient with minimal downtime.
Real-world success stories (runners and athletes): Beyond the reviews and theories, what about actual patients? One recent study looked at 40 runners (mostly women around age 30) who had various bone stress injuries that weren’t healing. These runners started focused shockwave therapy about a month after diagnosis, with an average of five treatment sessions each. The result: all but one runner (who had a severe navicular fracture and chose surgery) were able to return to pain-free running after completing shockwave therapy – and no complications were noted. Most of them healed and got back to running in roughly 2–3 months, even those who had more advanced stress injuries. Another smaller case series of soccer players with chronic stress fractures showed that after 3–4 shockwave treatments, all athletes’ fractures healed and they were back to playing in about 8 weeks. These studies give a clear message: shockwave can significantly boost healing in stress fractures, helping people get back to the activities they love.
How it compares to other treatments: There are other adjunct therapies for bone healing (for instance, ultrasound therapy or electrical bone stimulators), but evidence on those is mixed. Shockwave therapy has the advantage of a strong track record in clinical studies for various bone conditions (including non-healing fractures and even early-stage avascular necrosis of bone). It stands out as a regenerative therapy that actually stimulates the bone to heal itself, rather than just masking pain. And unlike medications, shockwave doesn’t have systemic side effects. Of course, the research is ongoing, and no treatment is 100% guaranteed – but the consensus in recent literature is that shockwave is a safe, effective option for aiding stress fracture recovery.
In summary, research supports combining traditional care (rest and activity modification) with advanced therapies for the best outcomes. You should still avoid high-impact activity until the fracture heals, but treatments like shockwave can help accelerate the healing process and ensure a stronger repair. Always discuss with your healthcare provider which treatments are appropriate for your specific case.
(References for the curious: see the end of this article for scientific studies backing these findings.)
At Unpain Clinic, our approach to stress fractures is twofold: we aim to speed up the bone’s healing and also address the underlying causes that led to the fracture. Our clinic specializes in regenerative therapies like shockwave, and we’ve found it to be a game-changer for many patients with stubborn injuries.
Shockwave Therapy: We primarily use True Shockwave Therapy (a focused form of ESWT) as a key treatment for stress fractures. This therapy involves using a specialized device to deliver high-energy sound waves to the injured area. Don’t worry – it’s not an electric shock, and it’s done on the skin surface with a handheld applicator.
Most patients find it only mildly uncomfortable (if at all), and treatments are very quick (often just a few minutes focused on the fracture site). Shockwave therapy’s effect on bone is remarkable: it increases blood circulation and stimulates your bone cells to lay down new bone tissue, thereby jump-starting a healing process that might have stalled. Because it’s non-invasive (no injections, no surgery) and requires no downtime, you can literally walk out of the clinic and go about your day afterward – no casts or crutches in many cases. We’ve seen patients with stress fractures that hadn’t healed for months finally turn the corner after a few shockwave sessions, corroborating what the research says.
EMTT and Other Modalities: In some cases, we combine shockwave with Electromagnetic Transduction Therapy (EMTT) – another advanced therapy that uses high-frequency electromagnetic fields to stimulate cellular repair (it’s painless and done while you relax). For certain fractures, adding EMTT can further promote bone healing and reduce pain. We stay at the forefront of technology, so if there’s a safe tool that can help your recovery, we likely have it. We’ve even collaborated with physicians on cases like femoral neck (hip) stress fractures where combining therapies (for example, shockwave + EMTT + hyperbaric oxygen therapy) made a dramatic difference in healing.
Holistic Rehab and Support: Treatments at Unpain Clinic aren’t just about fancy machines – we also provide the human touch and expertise needed for a full recovery. Our team includes experienced physiotherapists and chiropractors who will assess your movement patterns and the factors that contributed to your injury. For instance, if poor foot biomechanics or weak hip muscles led to your stress fracture, we’ll address those through targeted exercise therapy and manual therapy. Often, we find that patients have tight or weak muscles around the area of the fracture (e.g. tight calves, weak foot muscles for a tibial stress fracture). Our therapists will guide you in specific strengthening exercises, stretches, and gait training to correct those issues as the bone heals. This not only helps relieve stress on the injured bone while it’s healing, but also helps prevent a recurrence in the future.
Personalized Care Plan: When you come to Unpain Clinic with a stress fracture, we start with a thorough evaluation. We’ll review any imaging you have (X-rays, MRI) and do a physical exam. Then we’ll create a tailored treatment plan. A typical plan for a low-risk stress fracture might include a few weekly shockwave sessions (usually 3–5 sessions in total, as research suggests many patients heal within that range), along with guidance on protected weight-bearing (maybe using a walking boot for a few weeks if needed). If you’re in a lot of pain, we’ll discuss pain management options too – though interestingly, shockwave itself often provides pain relief by reducing inflammation and releasing local growth factors. We’ll also advise on nutrition (ensuring you have enough calcium, vitamin D, maybe recommending supplements like vitamin K or collagen if appropriate) because healing a bone is a whole-body task. Throughout your treatment, our clinicians act like coaches and partners – monitoring your progress, adjusting your plan, and encouraging you each step of the way. Our goal is not just to heal the crack in the bone, but to help you as a whole person come out stronger, with better knowledge of how to care for your body going forward.
In summary, treatment at Unpain Clinic combines the latest medical technology (like shockwave) with good old-fashioned clinical expertise (rehab exercises, patient education). We tackle the pain, accelerate the healing, and fix the “why” behind the injury. Many of our patients are happily back to running, dancing, and living pain-free thanks to this comprehensive approach.
(For more about our shockwave therapy, you can read our page on Shockwave Therapy in Edmonton which explains how it works in detail.)
Let’s look at a real patient story to see how all of this comes together. (Name changed for privacy.)
Meet Jane, a 34-year-old avid runner and mother of two. Jane came to Unpain Clinic after dealing with ongoing foot pain for over three months. She initially noticed a mild ache on the top of her foot after increasing her running distances in preparation for a half-marathon. Thinking it was just a sore muscle, she pushed through the pain – until it got so bad that she had to limp and couldn’t run at all. An MRI ordered by her doctor revealed a stress fracture in her second metatarsal (one of the long bones in the foot). She was told to stop running and was put in a walking boot.
After 8 weeks, the fracture still hadn’t fully healed and walking long distances was painful. Jane was frustrated and worried that she might never run again.
When Jane visited Unpain Clinic, we performed a thorough assessment. We noted that she had very tight calf muscles and weak intrinsic foot muscles, which likely contributed to extra load on her forefoot. Her running shoes were also quite worn out. After discussing treatment options, we started a combined approach: focused shockwave therapy on the fracture site once a week, gentle EMTT to help with bone healing, and a rehab program to stretch her calves and strengthen her foot and hip muscles.
After just two shockwave sessions, Jane reported that her foot pain was significantly reduced – she could now walk around the house without the boot, pain-free. By her fifth session, an ultrasound exam showed signs of bone healing, and Jane was able to start doing short walks and light cycling as we guided her. Eight weeks into our program, Jane was thrilled to report that she was completely pain-free. We gradually reintroduced running with a walk-jog program under our guidance. Three months later, Jane completed a 5km run without pain, and eventually, she built back up to longer distances. Importantly, she also learned from her experience: she got new supportive shoes, and now varies her workouts and includes cross-training (like swimming) to avoid overstressing one set of bones.
She continues to do the strength exercises we taught her to keep her hips, legs, and feet strong.
Today, Jane is training for that half-marathon again – this time armed with more knowledge on injury prevention. She says the combination of shockwave therapy and guided rehab at Unpain Clinic “gave me my running life back.” Perhaps just as crucial, she feels confident that she can avoid future injuries because she understands her body better.
Every patient’s story is a bit different, but Jane’s case shows that even if a stress fracture hasn’t healed with rest alone, there are effective options that can get you back to the activities you love. Our team was able to identify why her injury happened and correct it, while also using advanced therapy to heal the bone. She went from feeling defeated to feeling empowered and pain-free.
(Note: Individual results can vary, but we share this story with Jane’s permission as an example of what comprehensive care can achieve.)
While professional treatment is key, there’s a lot you can do at home to support your healing and prevent future stress fractures. Here are some at-home guidance tips in plain language:
Rest (but don’t lose all activity): Allow the injured bone time to heal by avoiding impact activities (like running, jumping) for the duration recommended by your provider. This might be frustrating, but think of it as an investment in getting back to 100%. You can usually still do some exercise – choose low-impact options that don’t hurt. For example, try swimming, pool running, or cycling (if your doctor/physio says it’s okay) to maintain fitness without pounding on the bone. Listen to your body: if an activity causes pain at the fracture site, stop doing it.
Protect and support the area: Use any support device prescribed, such as a walking boot, brace, or crutches, as directed. These devices are meant to offload the bone. It’s tempting to ditch them early when you start feeling a bit better, but stick with them for as long as advised so you don’t re-injure yourself. Also, wear supportive shoes even in the house – a stiff-soled shoe can reduce stress on a foot fracture, for instance.
Nutrition for bone healing: Fuel your body with nutrients that promote bone repair. Make sure you get plenty of calcium (found in dairy products, leafy greens, almonds) and vitamin D (sunlight, fortified foods, or supplements) daily, as they are crucial for bone strength. Protein is important too – your bones are about 30% protein matrix. Consider adding a vitamin D or calcium supplement if your doctor recommends it, especially if you have known deficiencies. Also, avoid smoking and keep alcohol moderate – both can impede bone healing.
Pain management and icing: It’s okay to use ice packs on the painful area (15–20 minutes at a time, a few times a day) to reduce pain and swelling, especially in the initial weeks. Over-the-counter pain relievers like acetaminophen can be used if needed. Some doctors caution against taking too much NSAIDs (like ibuprofen) during bone healing because there’s some evidence they might slow bone repair – always use medications as advised by your doctor. Often, as the bone heals, the pain will steadily decrease on its own.
Gentle exercises (as appropriate): While the fracture is healing, you’ll typically do very gentle range-of-motion exercises or basic strengthening that doesn’t stress the fracture site. For example, if you have a stress fracture in the foot or ankle, you might do toe curls, ankle circles, or calf stretches to maintain flexibility and blood flow (as long as these are pain-free). If it’s a hip or pelvis stress fracture, your therapist might have you do core and glute exercises that don’t load the injured bone. Always follow the guidance of your physiotherapist or doctor on what exercises are safe to do at each stage of healing.
Gradual return to activity: Patience is key. When your healthcare provider gives you the green light, return to your sport or activity gradually. A common mistake is to jump back in at full intensity and then get hurt again. Instead, follow a step-by-step plan. For running, a walk-run program is often used (for example, alternating a few minutes of running with walking, and slowly increasing the running). Increase your activity level week by week, not day by day. A good rule of thumb is the 10% rule – increase your training volume no more than 10% per week once you’re back. And keep at least 1–2 rest days per week in your schedule to allow your body to recover.
Address the root causes: Use this downtime to your advantage by working on factors that might have led to the stress fracture. If you have flat feet or high arches, talk to your provider about whether you might benefit from temporary orthotics or shoe inserts for extra support when you resume activity. Work on muscle imbalances – for instance, strengthen your calves, feet, hips, or core as directed. Check your form or technique (maybe get a coach or physiotherapist to evaluate your running form, dance technique, etc.). Small changes, like adjusting your stride or cadence in running, can reduce stress on certain bones. Also, check your equipment – this is a great time to get new running shoes or cushioned insoles if yours are worn out.
Remember, healing is a process. It can be hard to be patient, but your bone is doing a lot of work behind the scenes to repair itself. By taking these at-home steps, you’re actively participating in your recovery. And even after you’ve healed, continuing with good habits (proper training, cross-training, nutrition, rest) will help you stay injury-free in the future.
(Always follow the specific advice given by your healthcare provider, as every injury and individual is unique.)
It can be tricky, since early stress fracture pain can feel similar to a muscle strain or shin splints. The key difference is that a stress fracture typically causes a very localized pain on the bone that gets worse with impact. Shin splints, for example, cause a more diffuse ache along the shin and usually improve with rest. With a stress fracture, you might initially only feel pain during activity, but as it progresses it can hurt even at rest or at night. Swelling might occur over the site. The most definitive way to know is through medical imaging. If in doubt, see a healthcare professional – they may order an X-ray or MRI. Don’t try to push through severe bone pain, as that can worsen a potential fracture.
For a uncomplicated stress fracture (low-risk location) treated with rest, about 6 to 8 weeks is a common healing timeframe for the bone to mend enough for normal activities. However, it can vary. Some smaller stress fractures (like a minor crack in a toe bone) might heal in 4–6 weeks, whereas a more significant one (like in the pelvis or a high-risk area) could take 8–12 weeks or more. If the stress fracture was caught later (after it had worsened), it might take longer than 2 months. The good news is that therapies like shockwave can potentially accelerate the timeline of healing in some cases, or help a fracture heal if it was stagnating. Your provider will likely schedule a follow-up X-ray or exam to confirm when the bone is healed enough for you to resume impact activity. Remember that healing isn’t just about the bone mending; it also includes rebuilding strength in the surrounding muscles which might have weakened while you rested. So, factor in a couple more weeks of rehab when you think about “recovery time” to get back to full speed.
Most stress fractures do NOT require surgery or a full cast. The mainstay treatment is rest and protection. Many stress fractures are managed with a removable walking boot or brace rather than a cast, so you can take it off to shower or do gentle exercises. This allows some mobility while still keeping weight off the bone. Surgery is generally a last resort, reserved for fractures that won’t heal on their own (for example, certain high-risk fractures like in the hip, or if a stress fracture has progressed to a complete fracture). Thanks to advances like shockwave therapy, the need for surgery has become even less common. If you follow your rehab plan and the fracture is in a low-risk area, you have a very good chance of healing without any invasive procedures. Always follow up with your doctor – they’ll let you know if your particular fracture is the type that might need an orthopedic consult. But rest assured, the vast majority just need good conservative care.
Shockwave therapy feels like rapid, rhythmic tapping on the skin. Some areas may be tender, but most patients find it very tolerable — and we adjust the intensity to keep you comfortable. Each session takes just a few minutes.
It’s non-invasive, meaning no injections, no cuts, and no downtime. You might feel a little soreness afterward, but that’s a normal part of the healing process. Studies show shockwave is very safe and effective for treating stress fractures — with far fewer risks than surgery. It’s been used in orthopedics for decades with excellent results.
Focus on smart training habits and recovery:
Build up slowly – increase activity by no more than 10% per week.
Cross-train – add swimming, cycling, or yoga to reduce impact.
Fuel well – get enough calcium, vitamin D, protein, and water.
Wear proper shoes – supportive and not worn out. Replace every 300–500 miles.
Strengthen & stretch – work on hips, feet, core, and flexibility.
Rest matters – take at least 1 rest day a week and sleep enough.
Listen to pain – don’t push through it. Early signs need attention.
Taking care of your body now can help you stay injury-free long term.
Yes – as long as your bone has healed and you ease back in. Start with low-impact options, strengthen weak areas, and avoid sudden changes in training. A physiotherapist can help guide your safe return.
Stress fractures, while small in size, can be a big disruption in the lives of active people. The good news is that with proper care, they do heal, and most people can safely return to their sport or daily activities. In this article, we covered what stress fractures are (tiny cracks from overuse), why they happen (too much stress, not enough recovery, sometimes combined with other factors like form or bone weakness), and how to treat them effectively. The traditional prescription of rest remains fundamental – you have to give the bone a chance to mend – but we now have cutting-edge treatments like shockwave therapy that can significantly speed up and enhance the healing process. At Unpain Clinic, we combine these advanced therapies with holistic rehabilitation, tailoring the treatment to each patient’s needs.
The journey to healing a stress fracture requires patience, but you won’t be doing it alone. With a supportive healthcare team and the right approach, you’ll be amazed at how your body can repair itself. And perhaps just as important, this can be an opportunity to come back stronger – correcting the issues that led to the injury and adopting better habits moving forward. Many of our patients not only heal their stress fractures but also improve their overall fitness and knowledge, so they feel empowered in their long-term health.
If you’re dealing with a stress fracture (or suspect you might have one), don’t lose hope. By addressing it proactively and getting the appropriate treatment, you’ll be on the road to recovery. Imagine yourself soon lacing up your shoes again for that run, or heading back to the dance studio, or simply walking pain-free – that is very much within reach. The body has an incredible capacity to heal, especially when we give it the help it needs.
Healing is a team effort, and Unpain Clinic is here to help you every step of the way. Our approach is empathetic, warm, and rooted in the latest medical evidence – the kind of care we would want for our own family. If you’re tired of pain dictating your life, or if you’ve been resting an injury that just isn’t getting better, let’s talk. We offer personalized treatment plans for stress fractures and other hard-to-heal injuries, combining world-class technology with genuine care and understanding.
Don’t let a stress fracture keep you on the sidelines. Take the next step toward getting better.
We’ll thoroughly assess your situation, answer all your questions, and chart out a plan to get you back to doing what you love – pain-free and stronger than before. Remember, you don’t have to simply “wait it out” or face it alone. With the right support, healing is not just possible, it’s expected. Let Unpain Clinic be your partner in recovery and beyond.
BOOK YOUR INITIAL ASSESSMENTContact us today, and let’s start your journey to being active and unburdened by pain once again.
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
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3. Furia JP, et al. Shock wave therapy as a treatment of nonunions, avascular necrosis, and delayed healing of stress fractures. Foot Ankle Clin. 2010;15(4):651-62pubmed.ncbi.nlm.nih.gov.
4. Beling A, et al. Outcomes Using Focused Shockwave for Treatment of Bone Stress Injury in Runners. Bioengineering (Basel). 2023;10(8):885pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
5. Moretti B, et al. Shock waves in the treatment of stress fractures. Ultrasound Med Biol. 2009;35(6):1042-9pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
6. Shockwave Canada (2024). Current Concepts of Shockwave Therapy in Treating Low-Risk and High-Risk Stress Fracturesshockwavecanada.comshockwavecanada.com. (Summary of research evidence)
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