Magic Touch
Surgeon and polo player Dr. Kenneth Bramlett explains how his knowledge of the game and his orthopedic surgical procedures have helped many players.
Article originally published by Hurlingham Polo at hurlinghampolo.com. The original article can be read on page 24-27 at https://hurlinghampolo.com/Backissues/2021/spring_21/.
I am an Alabama native from a large family. From as early as elementary school I planned to go to medical school and worked hard to accomplish that goal. I was fortunate to live in Birmingham, Alabama, where the number one industry is healthcare. When I began medical school, there was no doubt as to the specialization of orthopedic surgery as a career, and I was given great opportunities to work with our excellent chief at the University of Alabama Health Center.
All this led to the research, design and development training I received in the three Traveling Fellowships I was awarded in Hanover, Germany, University of Colorado and my final training at Mass General, Harvard Medical Center, Boston.
Today, 30,000 orthopedic cases later, I still have a great time reengineering the processes of patient education, surgical delivery, and advanced rapid recovery rehabilitation for the myriad of cases I treat. I was able to revolutionize orthopedic surgical delivery when I instituted “prehabilitation”, a management process to prepare and educate clinically clear patients before all surgeries. This led to the initial “outpatient delivery model” in total joint, anterior cruciate and rotator cuff procedures in the early 90s.
These processes have been transformed over the years to allow immediate access to high level treatment, minimally invasive surgical integration and custom rehabilitation for our clients, many of which have been polo players, and their grooms, allowing me to be integrated into the game from a completely different perspective other than just my involvement as a player.
Most interesting is the story of Juan Martinez-Baez. In October 2019, his patron called me to tell me he was ill, and I flew immediately down the Point Clear, Alabama, where the tournament was live, and made a focal effort to find him. Not only did I find a player in a systemic wide septic shock from infection, he had become blind in one eye and partially in the other.
He had become immobile to walking, not to mention playing a game. I loaded him up and sent him direct to Robert Morris MD, a Retina Vitreous specialist in Birmingham. After six operations on his eyes and several of his joints, four months later he was recovered and riding again.
He had contacted “strangles” in the human form and we treated the infection invading his entire system. The world literature only has 25 reported cases involving the eye and vision and he, Juan Baez, is the only one of 25 who recovered their vision. Today he is a 4-goal player once more, teaching polo at different clubs and playing tournaments in the United States.
As a child we had horses on the family farm and always enjoyed riding. My time with horses was limited once I started the 17-year path towards becoming a specialty-fellowship training orthopedic surgeon. Once done, however, I was reunited on a clear October Sunday in 1994 at the Point Clear Polo Club in Fairhope, Alabama, with fast horses, super nice people and this addictive, exciting game — polo.
I have played now for over 25 years — long enough to raise a family who love the game, the people we have become friends with, and the beauty of the sport.
My sons play, which keeps me pushing forward as they do try to hook me when they can or finagle my string. We have a regulation field on our ranch and have employed many pros and grooms to come, stay, train and play with us over the years. We have a local club in South Alabama and travel to Point Clear, New Orleans, Atlanta, South Florida, Nashville and Argentina. In my medical travels I have also been called to treat players in Central and South America and the Emirates.
Polo is special because there are few sports which allow one to get a very high level of aerobic exercise, be deeply engaged in a high-level game strategy, ride a tremendously trained athletic animal, have such tight long-term social relationships with people from every walk of life, and have fun playing a most elegant game.
I have had the opportunity to play 4 – 16 goal tournaments, stick and ball, train horses and work to build a team with my sons over the past 20 years. It’s one of the few sports where a father and son can be on the same team playing and working truly equally together side by side.
The most memorable polo game I recall was an 8-goal tournament where my son score 6 goals in 2 chukkas on horses we trained and some we bred in our program we have worked hard to build on our ranch. This was one of his first big tournaments and it was great to see his efforts, our work and the training we have executed mature and come together. We have 24 playing horses currently, and I have restricted my playing over the last several years to 4-8 goal play the majority of the time. The reason being, not only do I have a very intense 6-day-per-week medical schedule, having gone through prostate cancer radical surgery and chemo and radiation in 2020, but I would rather play down from 0-1 handicap, and I must always be a little more careful as to who I play with and the quality of the game. It would not serve me or my patients well to have me be unable to operate and treat the clients who fly in the be treated. Playing polo and operating to fix injured clients are my two professional endeavors I keep in focus and to have one without the other is unthinkable.
The average professional polo player over 20 years of play will swing a mallet head millions of times, with a rotational force at over 130 mph. The mallet does make ground contact and the resistance feedback micro traumatizes the joints of the wrist, elbow and shoulder. I have treated numerous players for secondary effects of this repetitive motion and it is better to be proactive in the care process than reactive. The other joints involved are the neck and the lower back, with the hip and knee being the lesser major joints effected be the game.
Knowing polo and horses as a player myself gives me an advantage in understanding the efforts needed.
Dr. Kenneth Bramlett
In just the past two to four years I have evaluated and operated on a string of players, all who have returned to full play within two to three months. Knowing polo and horses as a player myself gives me an advantage in understanding the efforts needed, the schedule and the demand placed on the player trying to keep his level of play rising.
Professional player Tommy Collingwood described how Dr. Bramlett helped him to get back in the saddle to compete in high-goal tournaments just months after a fall in which he fractured his leg:
I suffered an intense spiral fracture to my right tibia and fibula while playing a tournament in Point Clear, Alabama on October 15 last year. I remember the sound it made when my leg broke as if it was yesterday. I knew right away it had broken, I just didn’t know how bad. My horse had slipped and fallen sideways and I got caught under her. It was the worst pain I have ever felt and I have broken several bones (both clavicles, fingers and ankle) but nothing like this type of pain in my leg.
Thankfully after being sent to the emergency room, and following X-rays, I was told I had to have surgery right away. Chip Campbell (team owner of high-goal team Cessna in Wellington) and other people in the area told me I had to see Dr. Bramlett. I spoke to him that afternoon and he said: ‘If you can come to see me tomorrow I’ll operate on you straight away’. I didn’t even hesitate — I flew that next morning from Point Clear to Birmingham which is about a 30-minute flight. That afternoon I was being operated on by Dr. Bramlett. I spent the night in the hospital and he came to check on me. We stayed chatting for about 3 hours since we both play polo. His plan was to do a 10-day check-up post surgery.
But what I couldn’t believe is that he sad to me: ‘If we’re gonna make it to the Wellington season, we need to start therapy right away and get your leg strong.’ Five days after surgery I was already in a swimming pool every day for an hour doing all my exercises that he recommended.
I can’t describe the pain, but I knew if I didn’t listen to my doctor I wouldn’t make it for the winter season. I went on a strict diet; took supplements to help quicker bone healing; did a lot of icing to keep swelling down, and about 6 weeks post-surgery I was slowly putting weight on my leg again. My goal was to make it for the semi-finals of the Gold Cup, which was scheduled February 10, since last year because of the pandemic the season was cut short. I knew that if I wanted to make it by then I would have to be able to be on a horse and be practicing way before that to see if my leg would be strong enough to handle the playing — especially at a 22-goal level.
If you talk to any doctors and tell them my type of break, they would have said it would be at least 6 months before I was on a horse again. I started riding January 1, two and half months after surgery. There as an 80 percent chance that I wouldn’t make it, but I put in my head that I had to beat those odds. I would talk to Dr. Bramlett just about every day and he would call to check up on me. I would send him videos of me riding and very three weeks an updated X-ray and we’d make plans based on that.
To sum up, around January 25 I was practicing flat out. I’d be lying if I said I wasn’t in pain, it was still very painful but with everything I have in my leg I knew it wouldn’t break again unless I had another bad fall. So it was mental strength that got me through the pain and got my leg strong again so I could make that semi-final.
I did, and we won against Juan Martin Nero and Pablo MacDonough, Marc and Melissa Ganzi. Apart from being so happy to win and make the finals of the Gold Cup, I know I wouldn’t have been there if it wasn’t thanks to Dr. Bramlett for getting me there physically and mentally. Unfortunately, I didn’t win the final, which was against La Indiana, Polito Pieres’ team.