Top Doctors / Advancing concussion care
A novel combination of treatments provides relief and results
Dr. Jeremy Rademacker, a specialist chiropractor, has been working with neurological doctors on concussion treatment.
Photos by Stephen Gabris
While the most common medical advice for a concussion is rest, a recent ground-breaking study published by Dr.John Leddy and his team at UB showed that properly managed exercise based on a standardized treadmill test can safely speed the recovery process for teenage athletes.
Concussions typically occur when ninety-five units of g-force—the unit used to measure gravity—or more are applied to the body. By comparison, a jet fighter pilot experiences an average of nine units.
Symptoms from a concussion may take two days or more to fully present themselves. It’s best to proceed with caution after a blow to the head even if you initially feel okay.
As Dr. Jennifer McVige, director Dent’s Concussion center, observes, “Kids naturally want to please and go back into the game,” which means it’s up to the adults– coaches and parents–to keep young athletes on the bench after a hit to the head.
Over the past few years, public awareness of sports-related concussions—from immediate diagnosis to long-term ramifications—has soared. Athletes and their families more fully understand the potential dangers inherent in many sports, from football and hockey to women’s soccer and cheerleading (which have roughly the same rate of concussions as men’s football). Concussions are far less likely to be shrugged off by athletes or swept under the rug by coaches and trainers and “concussion protocol” is now a term familiar to all sports fans. And, while sports-related concussions still grab the headlines—whether it’s Buffalo Bills center Mitch Morse or hockey superstar Sidney Crosby—those outside of the sports world are all-too-aware that you don’t need to be an athlete to have your world rocked by a solid blow to the head.
Several decades ago, I made a major miscalculation of height and distance and ran at full-force speed into a low wooden beam. My bell was rung loudly enough that I couldn’t brush off the symptoms—pain, brain fog, disorientation—and sought medical treatment. I was quickly diagnosed with a concussion and told that, with rest, the symptoms would fade. While the symptoms did indeed gradually regress, what followed was over a decade of excruciating, mind-bending migraine-like headaches that lasted entire days and rendered me completely nonfunctional for their duration. The negative impact on my life was immense as the lost days from suffering while fruitlessly grasping for some—any—relief added up. After completing a course of physical therapy with a local specialist without any discernible progress and with no possible solution on the horizon, I heard of a local chiropractor, Dr. Jeremy Rademacker in Orchard Park, who might be able to help me.
Having grown up in a family that embraced alternative healthcare options, I had been seeing chiropractors off and on for most of my life, but I quickly discovered that Rademacker is not your typical chiropractor. His practice is focused on the upper cervical area: the top two vertebrae of the spine and the occipital bone that covers the back of the skull. There are often patients in his waiting room who have traveled from across the country to consult with him. And his method of treatment is like no other I’ve experienced. Contrary to the bone-crunching, neck-whipping image that many people associate with chiropractic treatment, Rademacker’s manipulations of my upper neck and the base of my skull were so gentle and subtle that on my first visit I thought he was just getting started when he told me to stand up. He was finished. My neck had been restored to full mobility in minutes and, after a few follow-up treatments, the blinding headaches disappeared.
My curiosity was piqued, to say the least. On occasional subsequent visits to keep my head straight (literally), I’ve peppered Rademacker with questions in an attempt to understand the science behind the miracle he performed (his modest explanation is, “It’s all physics”). I’ve learned he is one of a very small percentage of chiropractors who have undergone extensive post-graduate training in upper-cervical-specific methodology. Batavia native Rademacker trained with the legendary Dr. Michael Kale, perhaps the preeminent pioneer in the field, at his clinic in South Carolina, before Kale tragically passed away in 2001 from automobile accident-related injuries. After working alongside Kale in his clinic, Rademacker became the head instructor there before moving back to Western New York to establish his practice. His practice grew through word of mouth, and his expertise landed him on the radar of area physicians.
While doctors are often suspicious or even dismissive of chiropractors, results ultimately speak for themselves. In Western New York, there is an informal and growing alliance of doctors, specialist chiropractors, and therapists in related fields working together with life-changing results to advance the treatment of concussions and related injuries.
Hockie goalie David Leggio worked with a range of medical professionals, including Dr. John Leddy and Dr. Jeremy Rademacker, after his concussion.
When hockey goalie and Williamsville native David Leggio, a former member of the Sabres organization and net-minder for the 2018 US Olympic team, suffered a severe concussion playing in West Germany on March 2018, he found himself in a downward spiral that he found “scary” despite having suffered concussions in the past. His team lacked the staff to deal with his neurological symptoms, which, in addition to the pain, nausea, and grogginess typically associated with concussions, also included a range of intense emotional issues, a phenomenon that doctors and patients are now realizing can be triggered by a blow to the head. Leggio went online looking for available help and soon realized that his best options were right in his hometown, beginning with Dr. John Leddy, director of the Concussion Management Clinic at Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. Within days of landing back in the US, Leggio connected with Leddy and began working with a range of physicians that expanded to include Dr. Jennifer McVige, director of the Concussion Center at the Dent Neurological Institute in Amherst and, ultimately, Rademacker. His health restored today, Leggio makes a point to reach out to other athletes who are suffering from concussion-related symptoms and inform them of the full range of available treatment options.
McVige is front and center in the effort to address concussions. She explains how her experience lead her across the doctor/chiropractor divide to Rademacker. “From a neurological perspective, I see the issues when [chiropractic] treatment goes wrong. But, while reading MRIs, I could see instances—especially with a lot of the high-level athletes—where I knew that it wasn’t a concussion that was prolonging their symptoms, but rather their upper cervical area where nerves were being compressed or irritated, causing their headaches, moodiness, dizziness, or anxiety. I thought that if we could fix that issue, we would have a better picture of what the concussion looked like. Whiplash is inherent in any head injury. You can have both a neck injury and a brain injury and, if you don’t address both, the patient is not going to have the optimal chance to get better.”
As Rademacker explains, “Where the spinal cord exits the skull contains the most concentrated amount of the central nervous system in the least amount of space. A human head weighs approximately fifteen pounds, while the upper vertebrae weigh just several ounces and are super movable. The whiplash from a single blow to the head can trigger a range of symptoms post-injury. The upper neck has a lot of neurology that relates to the brain. A lot can happen in that area that can negatively affect the nervous and myofascial systems.”
“In my search to find someone who could help us with our efforts at Dent, I ended up meeting with Jeremy. I’d heard from a couple of people who told me, ‘This guy is very different; he’s got magic hands.’ The more I heard, the more fascinated I got,” says McVige, who decided to see for herself. “When you take care of a professional athlete, if something goes wrong, that’s my license on the line, because I’ll get sued for recommending this person. I have to be 100 percent convinced. I met Jeremy and observed him a few times. And then, because I suffered from migraines stemming from poor posture, he adjusted me and it was amazing! It was safe and more effective than the therapy I was undergoing. Jeremy has a beautiful healing quality. He hones right in on the problem and it takes just a little bit of focused treatment. It’s almost magical.”
“Magical” may not be a precise medical term, but for anyone suffering from the physical and emotional fallout of a concussion, when relief finally occurs, it can indeed feel miraculous.
Dr. Jennifer McVige is director of the Concussion Center at Dent Neurological Institute.
The full range of what can happen after a concussion is becoming clearer. When The Athletic published a detailed account of Buffalo Sabres forward Kyle Okposo’s harrowing experience after suffering a concussion during a routine practice session, the report generated international response. By any measure, it was a riveting personal-interest story of a man and his family triumphing over a physical and emotional nightmare. But what hit home in the account for Clarence Center chiropractor Dr. Andrew Pruyn was the brief mention that the pivotal treatment for Okposo had been administered by a soft-tissue neurological-focused chiropractic specialist (not named in the account). Pruyn knew the story all too well.
A former college hockey player, Pruyn was pursuing a successful career as a licensed personal trainer when a truck ran a stop sign and rammed his car, giving him a concussion that turned his life upside down. “I had to stop working and was dizzy and nauseous for months,” he explains. “Just taking a shower was an ordeal.” Traditional physical therapies only seemed to make his condition worse.
Pruyn was referred to a chiropractic specialist who, in addition to setting him on a course back to recovery, changed the course of his life by encouraging him to become a chiropractor. As a hockey fan, Pruyn was well aware that Sidney Crosby’s career had been saved by nontraditional chiropractic treatment. As Pruyn soon learned, Crosby had been treated by Dr. Frederick Carrick, the founder of chiropractic neurology while at Life University in Atlanta. Carrick’s treatment methods are controversial in some traditional medical circles, but their underlying concept resonated with Pruyn’s experience as a trainer, and he decided to pursue chiropractic studies at Life. He returned to WNY to begin his practice with an unorthodox business approach. Confident in his ability to help his patients, he eschews advertising or accepting insurance. “I was told that I was committing professional suicide,” he explains today with a bit of a chuckle. But word spread and, within a short time, his schedule was booked.
Like Rademacker’s, Pruyn’s treatments are gentle and he often collaborates with physicians outside of his field. He rejoices when patients are healed after years of struggling with their symptoms. “I was treating a woman for back pain when she casually mentioned that she had suffered from migraines since the age of six,” he shares. “She had just accepted her suffering as part of life. I was able find the root cause and effectively address it with several treatments.”
While the term “medical miracle” conjures up dramatic images of cancerous tumors disappearing overnight or a patient awakening from a years-long coma, Pruyn notes that for anyone suffering from debilitating chronic conditions—often the result of a concussion that wasn’t properly diagnosed—real relief feels like just that. “When I see a patient who has almost given up hope, and then I’m able to give them back something that’s been taken away from them, their appreciation is my greatest reward,” he says.
McVige likewise stresses that, with the range of available treatments, “you do not have to suffer in silence, waiting for a miracle.” She adds that new medications that patients may not even be aware of can also lead to phenomenal results.
With the survival of multi-billion-dollar industries (consider the National Football League alone) now riding on their ability to properly prevent and address head and neck injuries, the treatment of concussions will undoubtedly remain at the medical forefront. Western New Yorkers, whether professional athletes or not, can take comfort in knowing that should their bell ever get rung, it need not take a permanent toll. Some of the best care in the world is available right here.