Max Adler immediately grabbed for his leg after hitting the turf.

Following another battle with the Philadelphia Barrage’s Alex Woodall in the third quarter of the Denver Outlaws’ second game of Major League Lacrosse’s truncated 2020 season — and Denver’s second game in as many days — the faceoff specialist found himself lying on his back as pain shot through his hamstring.

Muscle cramps.

It wasn’t the first time Adler ever experienced cramping. After all, he said, he trained in Florida’s summer heat to prepare for MLL’s 20th-anniversary season.

But after Outlaws trainer Randall Neal helped the faceoff man to the sideline, Adler didn’t have his typical recovery.

Cramps continued working their way up Adler’s body and into his abdominal area as the training staff worked with him to regulate his body temperature. On a summer Sunday in which the temperature on the Navy-Marine Corps Memorial Stadium turf crept well past the 100-degree mark, that task proved difficult.

According to Neal, Adler was put into an ice bath and was also pumped with about 100 liters of fluid to reverse his trajectory. But Adler’s second game day of the new season would end with a trip to the hospital for additional blood work.

“I’m not really sure why it happened,” Adler said. “I know I'm in good shape, and I've done everything I could from a nutritional and training aspect to prepare myself for this many games in a short amount of time.”

Adler’s situation exemplifies the ongoing challenges the league faces as it rolls through its season, condensed to a nine-day sprint because of the COVID-19 pandemic.

The league found a way to get its product on the field by shortening the season to just over a week’s worth of games that culminates with a championship contest this Sunday (2 p.m. EDT, ESPN). 

It expanded its rosters from 21 to 25 allotted spots for traveling players and has allowed all of them to dress to combat the fatigue brought on by playing multiple games in a short window.

The league secured a place to play in Annapolis, Md., and found housing for its players in a nearby hotel. Teams are separated by hotel floors and all meals are individually packaged and prepared for athletes’ consumption in their rooms.

“We've got doctors for every team associated with local hospitals, so between those doctors and the hospitals, we built an extensive board that did nothing but meet on this and create protocols that are exhaustive,” said Carrie Gamper, MLL’s director of marketing.

The protocols were designed to make the Navy-Marine Corps Memorial Stadium field the only place that the athletes come in frequent contact with one another. 

There are roughly 250 people in the MLL bubble, and while MLL “is not allowed to divulge any medical information about anyone within the league,” Gamper said, its COVID-19 protocol “has produced a very high level of efficacy.”

But in a twist of fate befitting the way 2020 has unfolded thus far, a heatwave added another complication to the league’s plan. All of the dates in which MLL has played its games thus far have been above the average July temperature of 89 degrees in Annapolis, according to US Climate Data.

As part of its COVID-19 plan, MLL has decided not to use locker rooms, which the league deemed a likely spot for a potential outbreak to occur. It has also prohibited the use of fans on the sideline to limit droplets in the air that could potentially spread the virus, according to Gamper.

That means fluids, ice baths, shade and the occasional bathroom break are the athletes’ main resources for cooling off.

Trainers such as Neal are also equipped to handle players overheating with means on the sideline, although it is something they hope to avoid through preventative measures. 

Neal has encouraged Outlaws players to be as hydrated as possible throughout the week and has also given them Heat Guard salt tablets to help stave off heat-related fatigue.

If players still show signs of fatigue, trainers look to the ice baths as they attempt to regulate players’ bodies. Neal said that trainers had access to 14 cool baths for players to utilize if necessary during Sunday’s game.

Outlaws midfielder Mikie Schlosser spent time in a bath during Sunday’s game after feeling some effects of heat exhaustion, Neal said.

As was the case for Adler, the last resort in terms of on-field measures is hooking players up to an IV on the sideline, something that was “a first” for Neal.

The use of IVs is not uncommon in lacrosse — Neal points out that the Outlaws used them for precautionary reasons ahead of preseason games in Denver last year — but administering one under a tent on the sideline to comply with COVID-19 restrictions was a new experience for the trainer. It was a procedure the trainers felt was necessary given Adler’s state, according to Neal.

If a player is still deemed at risk for further health complications, a trip to the hospital is the next step. At this time, only Adler has been transported to the hospital for heat-related concerns, according to Gamper.

Given the circumstances presented by the pandemic, Neal believes MLL has done “a great job” creating a safe environment for players and staff. He added that the use of IVs both before and after games as further preventative measures is the lone tactic he would add to the league’s safety plan.

And in that lone case in which a hospital visit was necessary, Adler’s pain subsided. He was cleared to play, leaving him more irritated by how Sunday’s game unfolded than anything else.

“It’s pretty frustrating for me because of all my conditioning and training I've purposely done for this situation,” Adler said. “I work harder and run more during my training sessions. It was pretty frustrating to have that happen so early on in the game and early on in our tournament schedule.”

Adler had been looking forward to competing in 2020 since the conclusion of last season — one in which the Outlaws fell short of a championship with a 10-9 loss to the Chesapeake Bayhawks in the final — to rid himself of the “sour taste” in his mouth. 

His own personal setback brought on by the weather was unexpected and frustrating, but not  something he harbors any ill will over.

“I assume all risk,” Adler said. “I know exactly what I'm doing. I know exactly what I'm getting myself into, and I take responsibility for that.”

The faceoff man feels comfortable putting it behind him and moving forward with the goal of an MLL title in mind.

“I'm just happy that we’re having the season to be completely honest,” Adler said. “I think this was the best way and really the only way to do it.”

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