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  1. My 20 year old son just saw his podiatrist. He recommended custom orthotics. My son has low arches and overpronates a bit. The outside of his shoes’ heels get a bit worn down (same with my husband). He also walks with his feet pointed out in a V, like my dad. Are there exercises he can do that will strengthen his arches and help his feet turn inward? He plays football in college and has gained 45 lbs over the last 2 years. He lifts and trains religiously. He’s solid. He’s had shin splint troubles this summer. We are always barefoot in our home, but never outdoors.
    I see that you do not recommend orthotics. If you find the right exercises and wear the proper footwear, is it possible to permanently alter the outcome so that your feet are facing forward and your arches are more noticeable as an adult? thanks -Barbara

    • Don’t be concerned about the arches. Arch height means nothing. Read this: http://www.drgangemi.com/2012/03/flat-feet/. Depending on how much he has developed the way he is now will determine whether you can get his feet straight, and for the most part it doesn’t equate into pain. (I don’t see how orthotics can even do that anyway.) Since he has shin splints there are imbalances and those can be corrected regardless of which direction his feet point – check out the SS Video on this site.

  2. I have recently been having terrible foot pain around the fourth toe of my right foot. I have gone to a couple different doctors, a podiatrist and a chiropractor. Basically, I am told that it is just the alignment of my foot. I have had some cold laser on it but have not noticed much of an improvement. My toes want to come forward, therefore, causing pain on top of my foot below my fourth toe and on the bottom of my foot, under my fourth toe (ball of my foot). I was given custom orthotics to wear to correct the alignment of foot. I also have high arches but they collapse when I walk. The orthotics seem to be causing ankle and calf cramping on my left leg and I notice pain in my left foot now which was never there before. Is that normal for an orthotic to do that? Do I need orthotics? I was also told to use a gel insert when wearing sandals to pull the top part of my foot down so my toes do not come up as much. How can I get my feet to be pain free again?? I would appreciate any info you can send my way. Would smart toes help? Thanks so much!!

    • You need to find a doc who looks at the entire body and can treat you in such a way. I’m sure you know my views on orthotics from reading even just a little bit of this site.
      I’m not sure what smart toes are – I sometimes use Correct Toes.

  3. Hi Dr:

    I have seen your videos and they have given me lots of hope. I was on Cirpo 500mg for about 3 weeks and then on Levaquin 750mg for about 10 days. I was supposed to be on the Levaquin for 6 weeks but on the 10th day felt a sharp tightness and sensitivity in both Achilles tendons as if they were going to snap. This was on November 18th, 2012. I stopped it immediately and am now on Bactrim which I am using to battle prostatitis.

    In any case, the pain and sensitivity was never like that first day but it’s been almost a month and the symptoms while waning on and off are still there. I went to a podiatrist and he put me on Meloxican 7.5 mg for 2 weeks and said no x-ray and MRI was necessary because 1) I had no rupture and 2) even if I had some micro-tears, all I could do is rest, take NSAIDS, and give it time to heal. He said 6-8 weeks.

    I then saw an Orthopedic Surgeon who took me off the Meloxicam and told me to take Voltaren for 2 weeks, rest and get a trigger point foam roller to massage the calf area. He said recovery could take weeks or months.

    I got online and saw that stretching may help and I tried the wall stretch and toe stretches and stair stretches but strangely this weekend my Achilles flared up a bit again. I got on your site and saw NO stretching and so I will not stretch for the forseable future.

    Can you give me a rough, if even subjective sense of what the prognosis is for me and any tips or suggestions for my recovery? Can I fully recover from this? Thanks, doc.

    • Ah – the medication injury story. These aren’t uncommon. Someone takes a medication which causes or provokes a problem and they stop the medication but the problem doesn’t go away. This happens a lot more than what you realize. Though many meds have a shore half-life and are theoretically out of your body in a few days, they can sort of “trip a switch” in your body by how they affect your chemistry and cause problems long after you stop taking them. Plus, you’ve gone from one NSAID to another (to even another) – and they come with their own problems as I mention in the Sock Doc First Aid Series. Additionally, taking antibiotics affects a huge part of your immune system, which in turn can delay healing. (No, I’m not saying you should stop any meds, I can’t advise you on that, but just be aware of it.)

      So the only advice (which is a lot) I can offer you generally speaking is the Video on AT, and the articles, like the First Aid. Ideally you probably need to be treated by a doc who looks at the entire body as a whole if you don’t get any better. And yes, you can recover 100% – I believe everyone can if they do the right things and are healthy. I see it enough to believe it.

  4. (Doc i’m sry for posting here, i initially wanted to post on the PF article, but the site treats me like a spam bot ): )
    Hi Doc, I started to experience a pain in my right heel since 6 days ago when i put pressure on it and 8 days ago i wore a really high heel and walked around quite a fair bit in it. I dont wear heels often, just occasionally. I have 3 questions and i really hope you can answer them! ><

    1. When looking for trigger points, i noticed in the PF vid you captioned that 'Normally trigger points shouldnt be very sore' but when i look for trigger points, they are really really sore! Does this mean I have a deeper problem? :'(

    2. Also I feel pain whenever i walk barefoot, so I consciously tried to put less pressure on my right heel (where it hurts). Should I stop doing that unnatural walk and just walk naturally/ even though it will hurt?

    3. I always wear minimalist shoes/ cheap shoes I can get from the market that have flat and hard soles. It was only this year March I started to wear 'X' brand running shoes and initially when i started wearing it, there was a lot of cushion and I slowly got used to it. Considering that I only wear heels on rare occasions. Could this be the source of my PF? Should i then stay off that pair of expensive running shoe? Cause i never had any problem like now.

    4. One last question.. Would you recommend playing dancing games on kinect whilst wearing minimalist shoes? I really love to dance and even though it hurts, it is only then when i can forget about the pain even though its still there!

    Sorry for the loads of questions! I'm really really appreciative of your posts and vids. Thank you doc! :')

    Love from the equator, Singapore!

    • 1. I say that in the video? If you’re referring to the statement at the 2:40 mark that says “Normally these spots…” not trigger point spots. Trigger points are sore – because there is a problem. Get it?

      2. Be careful distorting your gait too much or you’ll end up with other problems. You might want to wear a shoe to cushion the PF some as it’s healing up.

      3. Yeah, I lot of so-called “minimalist” shoes are still over cushioned. Go back to what has worked for you.

      4. Yes I would. Ideally you should be as minimal as possible (as you’re able to) all the time.

  5. Thanks for the great info! Walking barefoot as much as possible is providing me much needed relief and allowing me to feel how my shoes are causing much (all?) of my foot pain. What do you mean by minimalist shoes? Can you give suggestions of brands. (I have narrow feet “A” or “B” width depending on the brand). Always have to buy expensive shoes to fit. Do you know of “Earth shoes?”. What is your opinion on Birkenstocks?

    Thanks for all so far! Best in the New Year. Bill

  6. My 11 year old son started complaining of pain right above his arches on both feet about a month ago.I took him to a podiatrist and he was diagnosed with flex flat feet. The podiatrist has recommended custom orthotics and hopes that this would help him with the pain. He also stated that my son may be too old to straighten out the pronation, as he should have been wearing orthotics from a young age. What can you recommend to help my son with his pain in the arches.

    • You need to find a doc who knows what they’re talking about. FFF has nothing to do with overpronation and orthotics on a growing child are harmful in more ways than one (foot development, balance). Of course if he’s put in orthotics then the chance of him correcting any foot imbalance is slim to zero

      • What type of doctor should I take him too. I am really concerned as he complains of foot pain right above the arch. He does walk barefoot at home. Are there any type of exercises that you can recommend so help with his pain. I would like to help my son so that he can continue to be a kid and not have to deal with the foot pain.

        • The video on Foot Strength would be the exercises to do.

          For a doc you’ll need to find one that evaluates and treats the entire body – that may be a chiropractor, PT, or another practitioner — hard to say since you need to find a therapist rather than a therapy. Of course you’re always welcome to bring him to NC to see me.

  7. Hello.I hope you have some advice for me. I willl try to keep this short because I know you are a busy man.

    Eight years ago I had inflammation and pain in my hips and knees. I did the x-rays, MRIs, PT, and rest but nothing helped. I eventually got orthotics. (I know you are cringing right now) I am not sure what eventually helped. But after about two and a half years the pain went away. I got a tempurpedic mattress and I think this helped alot.

    I have not had any injuries or pain since until…
    Fast forward to February 2012. I decided to run in the minimalist five finger shoes. I wasn’t smart about it. I dove right into running in them. I had been runnning in the typical running shoes (with my orthotics) for the past five or so years with no issues.

    I ran in the five fingers for about six weeks. My ankles and calves were tight, sore, and in pain, but (stupidly) I ignored the pain and thought once I adjusted it would go away. After six weeks the pain was so bad I stopped running.

    Since Feb, 2012 I have been in pain. The tightness in my calves went away quickly but the pain and tightness along the outside of my feet has stayed. I went to an orthopedic in Jan. 2013 He did x-rays and nothing is fractured or broken. He diagnosed me with peroneal tendonitis and advised rest and PT. I went to PT. She mainily massaged the outside of my lower leg. We also stretched my calves and peroneal muslces. (more cringing for sure)

    While doing completely nothing (outside of PT) has made the pain and tightness slightly less, I don’t think I am doing what I need to do to address the real issue. I walked on the treadmill for 20 mins the other day (this was the first attempt at exercise in many months) and the outside of my foot has been tight and in pain just like I never took any time off.

    My feet are the tightest when I wake in the morning or after sitting for any period of time. After I am up and on them the pain and tightness lessens or even appears to go away. I am on my feet for at least 8 hours a day at work and for the most part standing and walking at work is okay.

    If I went for a short jog right now my feet would not hurt as I exercise but later they would stifffen up and hurt. I have never had any swelling or bruising and no spots on my feet and ankles hurt to the touch. The pain/tightness is along the outside of my foot but mainly at the end of my fifth metatarsal. If I wear any shoes that are tight is that area it increases the pain.

    This injury is really affecting my life. I am beyond frustrated because being physical active was such a large part of my life. Any advice you have would be greatly appreciated. Thanks for your time and I hope to hear from you soon.

    Stacey

    • Start by working out the trigger points in the calves as I show in many of the Foot Videos. Then you need to find a minimalist type shoe that works for you, probably not zero-drop.

      BTW – I cringe at tempurpedic mattresses as much as orthotics. Those things support your body too much when you sleep – you’re unable to freely move, essentially locking your body into unfavorable positions.

      • I just paid 250 for Orthotics wore them 2 days and my back has been locked in the worst pain for 3 weeks since I wore them.

  8. sir i m fitness trainer but i confuse few day many people say and i see many website that stretching do every day but your site different so i thing my guises that stretching week few day but yes so please give my ans ; Q ;why do week two day stretching Q i accept your guide that daily do not use stretching exercise because muscle do not use daily routine because muscle daily use muscle break down i m asking u i m right please give my ans;

  9. David Weiss says:

    I have had bilateral achilles tendonitis for over 20 years. Right now it is so bad that 100 yards of walking will aggrevate them. Over the years they have become progressivle worse. i am 56 years old and very fit. I recenlty went to a highly recommended physical therapist for the tendons. He said they were inflammed and very thin, probably a result of so many years of inflammation. He recommended 3 months of no exercise, and that I should wear a 3/8 heel lift for 3 months, then progressivly reduce the size of the heel lift. He also said after the 3 months of rest, when the inflammation was gone, he would give me strengthening exercises for the achilles tendons. Does this seem like a reasonable approach. I asked about going barefoot and he said maybe after a year. Thanks for your advice.

  10. Felicia De La Rosa says:

    Hello Soc Doc,

    My 22 year old son now has deformed feet. When he was younger we took the advice of a podiatrist and made him wear arch supports. This went on from the time he was 10 until he stopped wearing them at 15. I feel awful that we didn’t investigate this further before doing this.

    What should he do now? He’s embarrased by the way they look and I’m sure he has some pain.
    HELP!

    Guilty Mom

  11. Mark Williams says:

    I have been experiencing pain on the back of my heel. It is almost like it is bruised. When I am home in the evening and get up to walk in my barefeet, it really hurts and feels stiff. It seems to get slightly better after walking for a few minutes. I know you have talked about heel pain in the bottom of the heel but this is on the back of my heel.

    Some background info. The heel is on my left leg which is 3/8 of an inch shorter as a result of breaking both bones in my lower leg. I wear a lift in my shoe to compensate. Also, I tend to walk on my toes ever since I can remember.

  12. Thanks for your excellent Blog on Aches & Pains.
    I have been suffering from Achilles Tendinopathy (posterior heel pain) which started after I had ankle sprain. After ankle sprain was healed I started getting pain in the heel within few weeks. Its been more than 3 months (AT pain) have been to PT got some Acupunture service however pain still continued. I am 52 good health, normal weight. I walk everyday approx 10000steps. After reading your blog I took rest for two weeks which gave some relief and have reduced walking around 3000 steps –if I walk more pain comes back. I stopped stretching & No orthotics. I wear flat shoes to office (No Heel) I also purchased Trigger Therapy manual and have been doing myself.

    Do you feel if I put Ankle Brace for few weeks which may help in recovery ( i had used Ankle Brace for ligament sprain).

    Thanks for taking time to read and looking forward to your response.

    Sam Kapoor

  13. I have been wearing a custom fit orthotics for about 3 months now for plantar fasciitis. I have worked, standing, on concrete floors for the last 25 years. Also, I am overweight, and doing well in my weight loss with diet and exercise. But since wearing my orthotics, I now experience knee pain when I walk long distances. At times, it feels like my knee and shin bone is going to break in two. My husband thinks it is the orthodic correcting the way I walk and it will get better with time. Is this true, or do I have a new problem?

  14. Hi Steve,

    again I would need your advice on an knee issue:
    – about 1989 I had a stretched inner knee ligament
    – 2011 my right knee started to crack (kneebending below 90°) behind the patella, a following MRT showed a minor inner meniscus rupture an a light cartilage softening
    – since 6 month my knee starts to say there is a problem, no pain, but suspect feelings
    – my profession and training: MCT
    – my therapy: MovNat, Foam-Rolling/Trigger-Point, Ancle-Hip-Stability-Work, Stretching
    – what the knee doesn’t like: doing nothing, squatting/ground transitions without warmup, barfoot running
    – what it likes: intense MovNat-Training, squatting always feels good despite some light noise in the knee
    – statments:
    — Orthopedic 1: plain degeneration – no chance – stop kneeflexion
    — Orthopedic 2: your craniosacral system is completely rigid (I got fluidity now in it, but no consequences on the knee)
    — Chiropractic: perfect knee at my age (39), don`t worry, be a coach and not a trainee
    — Physiotherapist: the right patella is looser than the left one and seems to have a slight rotation, loosen the peroneus and the ITB, strengthen the m. quadriceps medialis
    – additional oberservations: when I move the patella I can find no painfull area but a unsoft area under the top of the patella; the tendoninsertion of the m. quadriceps medialis at the epicondylus is aching sometimes more sometimes less as well es the pes anserinus superficialis and thats the reason for the bad feelings in my knee.

    Hope you can give me some advice, I’m desperate and have fear I must stop doing squats and ground transitions;-)

    Beste Regards
    Bernd

  15. I just sent you a message, but guess I could have just posted it here . . .

    I have been having an issue for a few months. I have been running for decades, but just started forefoot running about 2 years ago.

    I run about 25 miles a week. Recently, I have developed abrasions (linear calluses) below my second toe (metatarsal area) on both feet. This area gets slightly swollen after a long or short fast run. I get in a couple speed runs during the work week which aggravates the area.

    I currently wear Newton Momentum trail running shoes (my long runs are done mostly on trails), but have had this issue in advance to purchasing these shoes.

    How can I treat this issue and prevent it from reoccurring?

    I really appreciate your advice!

  16. Hi – I wanted to follow up and share my positive experience with what I have learned on this site. About a year ago in August I was miserable as my running was stopped in its tracks due to what I thought was PF and runners knee. This site encouraged me to pack in my expensive physio and rigorous stretching routine – that was producing no results – and begin a strength training routine to address muscle imbalances. All my previous issues have cleared up. My runners knee disappeared. My PF is gone. Nike Frees are my regular trainer now. I run on average 40-50k a week with no pain and my old times have returned. In May my calf felt tight after a long run and it hurt to run the next couple of runs. I thought I was a gonner, but I remembered what I learned here about pressure points. I found the area high up my calf almost behind the knee. I worked it out and all was better. I now pay attention to these areas and it is part of my regular maintenance. Thanks for helping me get my running back on track. I am excited to be returning to the half marathon circuit. Regards – Dave

  17. In the interest of guiding women towards a healthier choice, can you explain or direct us to more information on why non-steroidal (copper) IUD birth control is not recommended?

    I recognize that “not recommended” may be understatement from your perspective; I want to understand WHY that is, and specifically HOW having an IUD impacts overall health.

    Thanks very much!

    • I am in the process of writing this article. It will be up on the drgangemi.com site the week of Feb 2nd. And no, “not recommended” is not an understatement as I think an IUD is ALWAYS a mistake.

  18. Hi could you please advise me on how to treat my sons Achilles problems, he has real pain on the back of the right heal & resting does not seem to make it better. He is 9 years old & enjoy doing sprinting but is struggling with his heel Thanks!

  19. Hi. My husband has bad plantar fasciitis. I would like to encourage him to go barefoot, but his orthotics have a wedge on one foot, as his legs/hips are uneven. He gets terrible back pain if he walks without his orthotics for even a few minutes because he is uneven. What can you recommend for him to go as close to barefoot, while keeping his body level?
    Thanks

  20. I have been having issues with my hips and buttocks. I have had an mri of my pelvis and lower back, everything came back normal. I have had an x-ray of my left hip, that came back normal. I also had a CAT scan of my pelvis and abdominal area, again normal. I cannot sit for a long period of time and my left butt and hip always hurt. The doctors all say it is probably muscular. I have been going to physical therapy for about 1 year now with no relief, they have me doing stretches everyday. Please help, before this I was very active and now I don’t do much. What do you recommend?

  21. Nick Salem says:

    Doctor : I have Calcified Achilles tendon at the back of my heel verified by X-Ray . I did eccentric exercises and stretching and for the most part I am pain free . But I am now left with a small Bump on one heel like you have . My question is will your treatment also break up or treat calcification of a Achilles tendon at the heel and if so educate me as to why ?

    Than You Nick

    • No, typically once you have the calcification you’re stuck with it. It can however become more inflamed either due to friction (from shoes) or stress on the calf muscles.

      • Nick Salem says:

        Thank you Sock Doc . I am a bare foot type person and have quit walking for exercise . So what is your recommended treatment for my Calcification issue ? And if the pain with walking comes back , is surgery the answer ?

        Thank You Nick

  22. Hello Doctor, for years I have had symptoms in multiple tendons. Most of them started as injuries (ie. Wrist and elbow pain after bagging groceries, knee, ankle and arch pain after walking too much. These symptoms flared up quickly and persist even years after stopping the initial activity. Initially I was diagnosed with tendonitis, but recently saw a rheumatologist who believes it is fibromyalgia. I also have a lot of cracking/crunching in knee, ankle and wrist joints (has increased recently), which concerns me but the doctors say it’s nothing to worry about. All my blood tests come out normal except low vitamin D. Got blood tests done for Lyme and celiac which were negative. I also have a lot of bloating and acid reflux. I’ve been taking vitamin D, a whole foods multivitamin, cod liver oil and just started back on magnesium. I also eat kefir most days. My main concern is that I may be doing damage to tendons or joints. The rheumatologist says I am not, but I feel tendonitis-like pain when I do most things, so I’ve stopped doing a lot of things I enjoy. I also have to write a lot for work, which is difficult. Any thoughts are appreciated. Thanks!

  23. Hello!
    I am a fit and healthy 28 year old (female) I have been suffering on/off with sprained ankles and flat feet issues since my teenage years. In recent years the pain has increased to a more constant discomfort (bigger bone, inflammation, pain on,in and around the bone and under where the tendon runs) , so i went to see a Podiatrist. I was diagnosed with Accessory Navicular syndrome, prescribed orthotics and advised to use anti-inflammatory meds (although i don’t take meds) and a few exercises to stretch and strengthen the posterior tendon.
    I am a bare footed babe… Always have been about bare feet and thongs (flip flop sandals) as a full time life style! Being told my only option is spending 80% of my standing life in hard-supportive shoes with these expensive bits of plastic within, seems really rubbish! I have been told the posterior tendon is still in good condition.. But I am seeking other answers outside orthotics and surgery! So far I have found tropical climates relieve the pain, sand and barefeet..I’m really interested to read anything you have written or may have to say regarding this issue!
    Thanks!

  24. I came across your site after reading an article about being barefoot helps naturally repair flat feet.
    My search started with looking for new comfortable shoes for a long day walking, as next weekend I am taking my family to Disney World and will be on my feet all day for a few days.
    My feet are COMPLETELY flat, so much that they suction flat ground and make “kissing” sounds when I walk on wet pavement! They have a deep pronation and if you grab the foot and push it straight toward my leg (up) it naturally curves inward and will not go straight. I have worn insoles as a young kid, went without as a young adult, but about 12 years ago started wearing UCBL arches and they helped a lot with the pain. My most recent pair (from a manufacturer in New York, rather than the Hanger manufactured ones I had in the past) have not provided the comfort I had in the past.
    For shoes I have worn Timberland Pro steel toe boots (sneaker height, not tall), the main reason for picking this is my work, as a steel toe provides protection and I like the style and they seem to hold up well.
    As I mentioned the latest orthotics I have are not working well. My feet still feel pain (less than without them) when I wear them, and mornings getting out of bed I can barely walk, it takes a few minutes on my feet for the pain to subside to a tolerable level, or getting into a hot/warm shower. For my work I work long hours in the stage / audio production business. I am on my feet long hours, and probably walk a couple of miles on a good show day (back and forth inside a ballroom or arena)! I mentally block the pain while working but as I finish the day the pain comes to me.
    I REALLY want to get more into the minimalist ideaology and start to cure these feet that I had been told I will DEFINITELY NEED SURGERY to correct (and it is only a matter of time before the pain is unbearable enough for me to have no choice but go through!) but I have a couple of issues / questions:
    1) I am going to Disney world next week! I was thinking about New Balance or similar shoes that are “made for flat feet” with extra support in the arches; either to use along with my inserts or on their own if they provide enough support: This may help in the short run but apparently is not what I need in the long run! Would you have a recommendation of what I should look for atleast to get through this trip?
    2) I plan on getting some of these “minimalist”shoes as mentioned in one of your articles, but most of my week is spent working (50-75 hours many weeks) and I really need some type of protective shoes for work, steel toes preferred (but many ppl dont wear steel toes, and some get run over by a 3-4″ castor of a 200-400 lbs case, or a case dropped on their feet from time to time!) Is there any product I could get that could hopefully provide protection for work, but still provide the environment my feet need to start healing naturally? Obviously I will try to stay barefoot as much as I can at home.
    3) Finally, my wife has a hard time about “germs” and “dirt” what could be picked up from walking in the dirt, grass, or roads outside. Would some minimalist shoes be ok to stay in while going outside or is the goal to REALLY be barefoot, and is there any reading material or info to ease the threat of “picking up some virus or bacterial infection” from walking in something or getting a cut from something outside?

    Thanks in advance for all your knowledge you share, both on your site and with my personal issues!

  25. Sock Doc, just a quick urgent small question. I have recently healed from Pes Anserine tendonitis. Making the switch to minimalist. Got some old cheap Cross Trekkers shoes that I’m using for a transition shoe for past month because they have almost no heel. I am no runner, my legs are not in any shape to run with past hamstring issues. Since I only walk, can I go immediately to minimalist shoes? I’ve been walking barefoot around the house as much as possible. I love the feel of New Balance mt10 or something similar but I don’t want to hurt myself. But I will only be walking. Am I good then? Thanks! Love the site

  26. Maya Smith says:

    Hi Doc-
    I have FFF, and have been following your advice here….the exercises you give, transitioning to barefoot, etc… My question is: Is it advisable to “pull up” my arch when I’m standing barefoot? I’ve been doing this at home when standing, and in the pool at aqua exercise class, in hopes it would aid in strengthening my arch. Is this wrong?
    Also…I have brachydactyly in my toes (great toe is normal length). Do you think this condition is limiting, as far as having a good base of support in my feet?
    Thankyou!

    • I honestly don’t know on that one. I guess it would be okay but you strengthen the arch by focusing on the ends – the ball of foot and the heel. So all the barefoot exercises I still think are best either way.

  27. Dear Dr Gangemi,

    I am a golfer who struggles to protract my left scapula and retract my right (right handed golfer), during my backswing. My left shoulder just sometimes seems to stop, and I end up lifting my arms and stop rotating. Would scapula stability exercises help? (I have quite good T spine rotation, and extension is getting better).

    Kind regards

    Adrian

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