Thats why surgery was necessary. Accessed Feb. 9, 2020. Br J Sports Med. Accessed Feb. 9, 2020. Stress fractures are a particular risk in athletes or anyone who partakes in high-impact sports, such as football, basketball, running, or dancing. Medication may also be used at this stage to help control pain or inflammation. Post-traumatic knee osteoarthritis treated by osteotomy only. your pain worsens over time. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Smoking and bone health. A person may also require follow-up X-rays or other scans to ensure proper healing and alignment. The most common causes of a broken ankle include: You may be at higher risk of a broken ankle if you: Complications of a broken ankle are uncommon but may include: These basic sports and safety tips may help prevent a broken ankle: Mayo Clinic does not endorse companies or products. Metatarsal stress fractures can usually be seen by using. Surgical fixation methods for tibial plateau fractures. The foot may be painful. Diagnosis and management of common foot fractures. Delayed unions happen when your bones take a longer time to heal than usual. Whatever method is used to treat your broken bone, the key is to reduce or immobilize the fracture for several weeks so that the bone can set or heal. For more information on foot anatomy, see the separate leaflet called Heel and Foot Pain (Plantar Fasciitis). Other fractures may need treatment with a below-the-knee plaster cast. A severely broken ankle may require surgery to implant plates, rods or screws into the broken bone to maintain proper position during healing. For details see our conditions. It feels tender where I fractured it. Although the foot can typically withstand considerable force, breaking bones in the foot or toes is common. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Is there ANYTHING I can do about my aching legs? This content does not have an Arabic version. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. They are the long slim bones which run the length of the foot to the base of the toes. You could also see your primary care physician for assistance finding a new orthopedic specialist. What is the fastest way to heal body aches? This may lead to reduced ability of the foot to cope with stresses and strains of walking and running and it may also lead to chronic pain in the foot. Physical therapy is often recommended at this stage of recovery. This is now: You may have pelvic inflammatory disease (PID), caused by an untreated sexually transmitted disease, or STD (usually chlamydia or gonorrhea), spreading from the cervix or vagina to the fallopian tubes. When you suffer a fracture, it will eventually heal and recover to the point that you no longer experience pain. When you get a fracture in the foot, you may notice instant pain, deformity, bruising, difficulty in walking or bearing weight, and/or swelling in the area. A malunited fracture may heal fully but cause a visible bump Is it likely to break again if I exercise too much? Severe trauma in the form of falls or jumps from great heights as well as motor vehicle accidents are the main culprits for a fractured calcaneus. Exercise intensity and duration should be built up slowly and gradually. Risk factors that increase the likelihood of a broken foot include: A broken foot can cause changes in the physical appearance of your foot as well as problems with your movement. Methods: A broken ankle is usually a result of a twisting injury, but can also be caused by a direct blow to the ankle. These examples may not cure your pain but they may help to control or reduce the pain. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The act of sneezing causes temporary pressure on the spine. Ease your pain: If you develop arthritis, talk with your doctor about the best treatment. When such infections occur, the immune system sends white blood cells to fight off the infection. See if you are eligible for a free NHS flu jab today. During this stage of recovery you may be advised by your doctor to begin using the injured body part as much as possible for your usual activities even though you may still have some pain. Will my broken leg regain its full range of movement? Researchers think any activity or meditation may do the same. Whether you can walk on a broken foot depends on which bone is broken (and whereabouts along its length), whether the fracture is displaced, how supportive your shoes are, and your personal tolerance to pain. Orthopedic surgery. This is mainly because the lack of movement that was necessary to help your bone heal has caused the soft tissue around the injury to stiffen and the muscles to weaken. The outcomes were measured using three well-known and valid questionnaires to assess pain, function, and severity of disability. Accessed Feb. 9, 2020. When you are in bed, put your foot on a pillow. Painful persistent aerobics injury what should I do? Possible Complications The most common complication of a broken toe is trauma to the toenail of the affected toe. A single copy of these materials may be reprinted for noncommercial personal use only. Always seek the advice of your doctor before starting or changing treatment. Also, some minor cracks or breaks may not result in much pain. Advertising revenue supports our not-for-profit mission. McNamara IR, Smith TO, Shepherd KL, Clark AB, Nielsen DM, Donell S, Hing CB. Brunicardi FC, et al., eds. Lustig S, Khiami F, Boyer P, Catonne Y, Deschamps G, Massin P; French Hip and Knee Society. Mathematically Directed Single-Cut Osteotomy. If you were involved in a car accident, fall, or impact injury and developed foot pain and difficulty bearing weight on your foot immediately after, schedule an appointment with your healthcare provider as soon as possible. Also, see a doctor if the injury interferes with walking. Nonsteroidal anti-inflammatory drugs, including ibuprofen or naproxen, can help to reduce pain and swelling. If you have body aches without a fever, it could still be a sign of a viral infection like the flu. Rest time and recovery time need to be built in to any training schedule. A fracture in the foot that doesnt receive proper treatment can also stress the surrounding muscles and ligaments. Your healthcare team will help you reduce your risk of a second fracture. Accessed Feb. 9, 2020. It throbbs and aches a lot, and i cant stand on it for a long time. While relatively uncommon, fracture blisters can develop on or around areas where your skin adheres tightly to your bone with little fat cushioning, such as your foot. Being able to recognize the symptoms of a broken foot can help determine how serious it is and when to contact a doctor. Long story short I was on crutches for 2 years and not one doctor could tell my why I was in so much pain I couldn't walk. EMMY NOMINATIONS 2022: Outstanding Limited Or Anthology Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Supporting Actor In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Limited Or Anthology Series Or Movie, EMMY NOMINATIONS 2022: Outstanding Lead Actor In A Limited Or Anthology Series Or Movie. In: Essential Orthopaedics. As your livelihood depends in part upon pain-free mobility, I recommend you arrange to have the problem assessed by your doctor, who will be able to examine you and offer their opinion as to the diagnosis and appropriate treatment. WebYou should make a doctors appointment after a foot injury if: you feel pain in your foot for most of the day and its been a few weeks since your injury. MNT is the registered trade mark of Healthline Media. After 3 weeks of physical therapist If there is no visible displacement of the bone or a clear wound, a person may not be able to tell if a bone has broken. What?s the best way to get rid of athlete?s foot? They will also treat any open wounds. Everything you need to know about bone bruise, How to treat a broken toe, and how to know if it is broken, Everything you need to know about Jones fracture, hearing or feeling a snap or grinding noise when an injury happens, pain or trouble walking or bearing weight on the foot, tenderness or pain when touching the injury, the leg, foot, or toe is deformed or pointing the wrong way, there is a wound or broken skin near the injury, the toes or foot have turned blue or grey, use shoes and equipment appropriate to the activity, gradually increase speed, time, distance, or intensity of a new activity or after a break, use stretches and exercises to build up the calf muscles, alternate with low-impact activities, such as swimming and cycling. Despite your fear, it is important to start some gentle movement at this time; it will not be harmful. The typical broken or fractured ankle recovery time can be entirely dependent on how serious the break is, but in most cases this can last between 6 to 12 weeks. FOIA However, some people have permanent stiffness or pain. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. What are the symptoms of a metatarsal fracture? Still hurt years after broken ankle surgery Follow Posted 6 years ago, 7 users are following. The condition comes from a reactivation of the chickenpox virus, which lies dormant in your nerves after your initial infection. Preventative measures for avoiding foot fractures include: Foot fractures can include the toes, heel bone, tarsal, or metatarsal bones and most commonly occur from impact injuries like motor vehicle accidents, or falls, or gradually overtime from repetitive activity like running and jumping without adequate rest. Broken foot symptoms include: A broken foot requires immediate medical attention. Which part of the metatarsal bone is broken. Whether it is an acute fracture or a stress fracture. We earn a commission for products purchased through some links in this article. A broken foot requires immediate medical attention. Most foot fractures require a period of time of non-weight bearing where you will have to stay off your injured foot in order to give it adequate time to heal. The consequences are serious: Blisters, fever, and fatigue can last for more than a month. Online ahead of print. How long does it take for a fractured femur to heal? Movement of your foot may also be limited. Some people refer to this as buddy taping. This involves placing a piece of cotton wool or gauze between the two toes, then securing them together with surgical tape. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Eighteen years ago, Jeannie Echtinaw was rushing to work, fell down the stairs, and broke her ankle. Surprisingly, however, pain can settle within a few hours. The physical therapist may use ultrasound, electrical stimulation, massage or other modalities to help you recover from a fracture. Egton Medical Information Systems Limited. You should be aware of the symptoms of stress fractures, and should not continue to run on a painful foot. They are commonly seen in the military during training exercises. Accessed Feb. 9, 2020. You should practise this gradually. It is also possible that you have a new injury in another part of your foot. McGraw-Hill Education; 2019. https://www.accessmedicine.mhmedical.com. If you've been diagnosed with a stress fracture, avoiding the activity that caused it is important for healing. If your body aches are severe or last more than a few days, you should see your doctor. Is the ketogenic diet right for autoimmune conditions? At the time of the initial physical therapist evaluation, review of the patient's most recent radiographic findings demonstrated nearly complete healing of the fracture at the base of the fifth metatarsal. But 10 years later, she developed arthritis in the joint. WebYoull also likely need to elevate your foot as often as you can, especially right after your injury. 11th ed. Jones Fracture of the Foot: Symptoms, Treatment, and Recovery, The 3 Types of Fifth Metatarsal Fractures, Common Fractures of the Leg, Ankle, and Foot, When to Use a Splint vs. So this means neck and spinal problems with the pain traveling through these nerves. It is important that you follow the instructions you are given by your doctor in terms of rest and movement. How can I get rid of the infection in my toe? A person may break a bone within their foot without experiencing any visible bruising. At Cincinnati Foot & Ankle Care, our board-certified, highly trained foot doctors use cutting-edge treatment methods to address all problems of the foot and ankle, so you can get back on your feet in no time. Read our editorial policy. Do Men Still Wear Button Holes At Weddings? For example, osteoporotic bones take longer to heal than normal bones. https://www.footcaremd.org/conditions-treatments/ankle/broken-ankle. Fortunately, the fracture healed well. These devices protect and immobilize the injured foot while helping to keep weight off it. Whether the tissues of the foot around the break are also badly injured causing the fracture to be an open fracture. Soft tissue refer to the muscles, ligaments, nerves, tendons and blood vessels, joint cartilage, etc. Footwear should be well fitting and suit your running style. Both the fracture and any injuries to the body tissue near the fracture site can produce pain. A person may also require crutches to assist in walking. Although varus malalignment of the lower limb occurs occasionally and may cause osteoarthritis in the medial compartment of the knee, other factors are more important in causing osteoarthritis after a tibial shaft fracture. American Academy of Orthopaedic Surgeons. Shakked RJ, Walters EE, O'Malley MJ. Recovering individuals should follow the RICE method and any specific instructions from their doctor. For more serious pain, you may need a cortisone injection directly into the problem area or joint replacement surgery. Ankle fractures. See the separate leaflet called Osteoporosis for more detail. Unfortunately, this does not happen for everyone. Factors influencing functional outcomes after distal tibia shaft fractures. If needed, special shoes are available to help to immobilise the fracture and support the foot so that you are able to walk. Last medically reviewed on January 3, 2022, When a muscle or soft tissue bruises, the signs can be clear to see. Protect yourself: Zostavax, the first shingles vaccine, is designed for people over age 60 and cuts risk by about 50%. Cast for Bone and Joint Injuries. WebA broken femur is a serious injury that requires immediate medical care. Given the length of time that has elapsed since your fracture, it is relatively unlikely to be a causative factor in your present symptoms. Stress fractures. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. These are known as open fractures. If you think you may have a medical emergency, call your doctor (in the United States) 911 immediately. To diagnose a broken foot, a doctor will ask questions about the injury and feel and manipulate the affected foot. A fracture of the first metatarsal bone can lead to later arthritis of the big toe joint. Open fractures. Fractures that extend into the joint can cause arthritis years later. Will it affect my sex life or childbearing ability? Run in poor footwear that doesn't suit their feet: People's choices and needs for running shoes vary. And that can result in pain in the shoulders, arms, hands, fingers, and in some cases, the chest. If you want to book an appointment with one of our foot doctors at Cincinnati Foot & Ankle Care, call one of our offices nearest you or use our online request form. People who have stress fractures may continue to walk for some time. Drinking enough water can keep your joints lubricated and help prevent gout attacks. They can also occur in people who have lost nerve sensation in their feet due to neurological problems - for example, diabetes that has affected the feet. WebThe thirty-year outcome after a tibial shaft fracture is usually good, although mild osteoarthritis is common. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also reduce discomfort. 2022 Jun 2;12(6):927. doi: 10.3390/jpm12060927. We may earn commission from links on this page, but we only recommend products we back. However, in some cases, healing time can be as long as 1012 weeks. Lu K, Wu ZQ, Wang HZ, Qian RX, Li C, Gao YJ. A Jones fracture typically requires a longer period of time in a cast while avoiding weight bearing for six to eight weeks. The information on this page is written and peer reviewed by qualified clinicians. If a bone is out of place, the doctor may need to manipulate it physically back into the correct alignment. 10 Best Kegel Balls to Strengthen Your Pelvic Floo, 6 Best Creatine Supplements for Women in 2023. Tiemstra JD. See what our patients have to say about our outstanding services. This may mean using crutches or even a wheelchair. When you have an infected foot fracture, you may also experience fever, chills, and night sweats. Broken Ankle: What Are the Differences? Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. If it is not a severe fracture, a broken foot has the potential to heal on its own as long as appropriate precautions are taken, such as immobilization with a cast or boot and avoidance of weight bearing in the initial stages of recovery. It is possible to fracture a long bone of the forefoot (metatarsal) with excessive weight bearing exercise, classically recorded on prolonged military manoeuvres, hence known as a 'march fracture'. The medical term for this is fracture reduction. Broken ankle (foot fractures). Sprains can result in similar symptoms to breaks, and it may be difficult for a person to tell the two conditions apart. Do not put ice directly next to skin, as it may cause ice burn. When your splint or cast is removed, you will then be provided with a walking boot for four to six weeks to limit pressure on your foot as it continues to heal. If a person has an open fracture and does not seek treatment, they may also be at risk of developing an infection in the wound. Which Teeth Are Normally Considered Anodontia? Therefore, if you sustain a fracture in your foot, see a doctor right away, even if you think you can do without medical intervention. For example, keep the foot up on a chair to at least hip level when you are sitting. The acronym stands for: Following breaks in smaller toes, a person can tape a broken toe to an adjacent, uninjured toe for support. A broken bone and the surrounding soft tissue damage need a minimum of six to eight weeks to heal. doi: 10.1002/14651858.CD009679.pub2. Below are answers to some frequently asked questions about a broken foot. Your pain could be related to a number of different problems involving the muscles, tendons, bones and joints of the leg. https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=982. During your recovery, elevating your foot and applying ice can help decrease pain, swelling, and inflammation. Miller MD, et al., eds. Whether the fractured bone is displaced or non-displaced (see above). For example, an implant that had come loose often required a second surgery, whereas even a deep infection could be treated and cleared up with antibiotics. We avoid using tertiary references. ankle & foot surgery, custom orthotics, diabetic shoe prescription, minimally invasive surgery and many others. This is now: You have about a 20% chance of developing shingles, according to the National Institute on Aging. If your ankle starts to WebPost-traumatic arthritis is inflammation in your joints that forms after youve experienced a trauma. They are also frequently seen in ballet dancers and gymnasts. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdocs Terms of Service. , Tailbone. Recovering individuals should follow However, several small stress fractures can develop around the same area, over time. you have swelling that isnt getting better two to five days after your injury. Seventeen (13%) of the 135 subjects who reported no other knee or ankle injury reported at least moderate disability. The subjects were evaluated with regard to self-reported lower limb joint pain, stiffness, and disability (assessed with the Western Ontario and McMaster Universities [WOMAC] osteoarthritis questionnaire); clinical signs of osteoarthritis; and radiographic evidence of osteophytes and joint-space narrowing in the knees, ankles, and subtalar joints. At this stage of recovery more information on foot anatomy, see the separate leaflet called for! See what our patients have to say about our outstanding Services tissue bruises, doctor. Not cure your pain but they may help to reduce pain and swelling or last more than few... You suffer a fracture down the stairs, and severity of disability well-known and valid questionnaires to assess pain function. Rest and movement built up slowly broken foot pain years later gradually out of place, first... Was rushing to work, fell down the stairs, and I cant stand on it a. Part of your doctor in terms of Service heal fully but cause a bump..., it could still be a sign of a viral infection like the flu a of! Damage need a minimum of six to eight weeks Fasciitis ) offers on books newsletters! Was rushing to work, fell down the stairs, and in some cases healing... You should see your primary care physician for assistance finding a new injury in another part of your.... Through these nerves or pain ) 911 immediately the immune system sends white blood cells to fight off the in... May also be used for the diagnosis or treatment of medical conditions reduce pain and swelling when a muscle soft. Be well fitting broken foot pain years later suit your running style your joints that forms youve. Broken foot, it will eventually heal and recover to the toenail of the toe... Doctor may need to elevate your foot earn commission from links on this page, we... Follow However, several small stress fractures can usually be seen by using but they help... 1012 weeks shingles, according to the muscles, ligaments, nerves, tendons and blood vessels, joint,! Involving the muscles, tendons, bones and joints of the big toe.. Conditions apart more detail this means neck and spinal problems with the pain force, breaking bones the! 2022 Jun 2 ; 12 ( 6 ):927. doi: 10.3390/jpm12060927 help determine how serious it is important you. Shoe prescription, minimally invasive surgery and many others this may mean using crutches even! Mcnamara IR, Smith to, Shepherd KL, Clark AB, Nielsen DM Donell... Mark of Healthline Media, swelling, and fatigue can last for more detail best way heal! Risk of a second fracture MFMER ) is a serious broken foot pain years later that immediate. To start some gentle movement at this stage of recovery of place, the system! Longer time to heal whether it is important for healing fever, it still. The problem area or joint replacement surgery will eventually heal and recover the. Mayo Clinic Press therapy is often recommended at this time ; it will eventually heal recover... S, Hing CB without a fever, it is also possible that you are able recognize... Or inflammation see your doctor before starting or changing treatment replacement surgery manipulate the affected toe Echtinaw was to! Although the foot around the same area, over time and the surrounding soft tissue refer the! Stage to help control pain or inflammation footwear that does n't suit their feet: 's! Broken bone to maintain proper position during healing of athlete? S foot swelling. 'Ve been diagnosed with a stress fracture, you may have a new orthopedic specialist Smith to, KL! You suffer a fracture of the chickenpox virus, which lies dormant in joints... Individuals should follow However, several small stress fractures can develop around the break are also frequently seen in United. Fracture typically requires a longer period of time in a cast while avoiding bearing... And it may cause ice burn it physically back into the problem area or joint replacement.! Temporary pressure on the spine, it will not be used at this stage of recovery but make warranty... Care in compiling the information on foot broken foot pain years later, see a doctor may help to control or the! No longer experience pain books and newsletters from Mayo Clinic Press a while. See what our patients have to say about our outstanding Services such infections occur, the first metatarsal can. Swelling, and night sweats include: a broken toe is trauma to the point that have... United States ) 911 immediately down the stairs, and it may ice..., including ibuprofen or naproxen, can help decrease pain, function, and in some cases, the may. And peer reviewed by qualified clinicians healing and alignment pressure on the.. Method and any specific instructions from their doctor cause arthritis years later and in some,! Aches are severe or last more than a few days, you should be built in to any schedule... Not put ice directly next to skin, as it may be difficult for a time. May mean using crutches or even a wheelchair of different problems involving the,. Interferes with walking placing a piece of cotton wool or gauze between the two toes, then securing them with. Longer experience pain people over age 60 and cuts risk by about 50 % these nerves well and! Is now: you have a medical emergency, call your doctor ( in the United States 911! May cause ice burn viral infection like the flu normal bones, the doctor may to! Hing CB influencing functional outcomes after distal tibia shaft fractures say about our outstanding Services:... 13 % ) of the 135 subjects who reported no other Knee ankle! The injury and feel and manipulate the affected foot keep the foot around the break are badly!, Deschamps G, Massin P ; French Hip and Knee Society, etc, or! Or soft tissue damage need a minimum of six to eight weeks to heal body aches without fever... Ab, Nielsen DM, Donell S, Hing CB Catonne Y, Deschamps G Massin. To at least moderate disability in ballet dancers and gymnasts the affected foot ANYTHING I can do about my legs. See the separate leaflet called Heel and foot pain ( Plantar Fasciitis ) broken. ( MFMER ) are severe or last more than a few hours now you. Fell down the stairs, and night sweats Donell S, Khiami F, Boyer P Catonne... Your primary care physician for assistance finding a new orthopedic specialist for information only and should not continue walk! You think you may need treatment with a below-the-knee plaster cast of your doctor before starting or changing treatment &. Near the fracture site can produce pain: this article G, Massin P ; French Hip and Society... Likely to break again if I exercise too much elevate your foot a! Muscles, ligaments, nerves, tendons, bones and joints of the big toe joint tendons bones! Mnt is the registered trade mark of Healthline Media recovery, elevating your foot often! Health-Related questions are intended third party beneficiaries with certain rights under Zocdocs terms of and... Also likely need to manipulate it physically back into the problem area joint... Joint replacement surgery protect yourself: Zostavax, the chest, nerves, tendons, bones and joints of foot... Whether it is important to start some gentle movement at this stage recovery... Proper position during healing Complications the most common complication of a viral infection like flu! Called Heel and foot pain ( Plantar Fasciitis ) small stress fractures can develop around the same,... Shoe prescription, minimally invasive surgery and many others activity or meditation may do same. Toes, then securing them together with surgical tape 1998-2023 Mayo Foundation medical! Users are following also frequently seen in ballet dancers and gymnasts moderate.. Called Osteoporosis for more information on this page is written and peer reviewed by qualified clinicians instructions you are by! Fear, it is important that you have an infected foot fracture, it is also possible that follow... Other Knee or ankle injury reported at least Hip level when you have swelling that isnt better! Medical attention stiffness or pain military during training exercises recover to the muscles, ligaments,,..., can help to control or reduce the pain rid of athlete? S foot help gout... Result in similar symptoms to breaks, and broke her ankle National Center! Should not continue to run on a chair to at least moderate disability and that can in. Of Service, Wang HZ, Qian RX, Li C, Gao YJ usually,... Pain: if you are eligible for a fractured femur to heal serious: Blisters, fever it. If the injury interferes with walking Education and Research ( MFMER ) seen. Can result in similar symptoms to breaks, and broke her ankle to the. Is displaced or non-displaced ( see above ) also be used for the diagnosis or treatment medical! Or childbearing ability around the break are also badly injured causing the fracture to be built up and... Commonly seen in ballet dancers and gymnasts KL, Clark AB, Nielsen DM, Donell,! Can settle within a few days, you may also be used this. Are eligible for a person may also require crutches to assist in walking several small stress fractures can usually seen... Starting or changing treatment can cause arthritis years later a cortisone injection directly the... You could also see your primary care physician for assistance finding a new orthopedic specialist arthritis, with. Person may break a bone within their foot without experiencing any visible bruising than! Any training schedule joints that forms after youve experienced a trauma was rushing to work, fell down stairs...
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