CAPE GIRARDEAU, MO (KFVS) - Two Missouri familes mourn the deaths of their young sons after they died on the football field.
In New Madrid, Raymond Tindle died last week and an 8th grader died Tuesday in St. Louis.
Before those players were cleared to play, they had to pass a physical.
"I think it's very comprehensive and I think it does a very good job of looking at those athletes," said Dr. Jim Bowen of Cape Girardeau.
Physicals take about 15 minutes and Bowen says they catch about 99.9 percent of potential problems, but heart murmers are sometimes difficult to catch. Heart problems can also be detected during exercise.
"If someone tells me during exertion they get light headed, they feel fatigued, or they have chest pain, I'm doubly attentive to listening to the heart," said Bowen.
Once athletes are cleared to play, it's up to coaches and trainers to keep a watchful eye out for any warning signs.
"Are they starting to slump? Are they starting to move slower? Are they pulling in the wrong direction if they're a lineman? Are they running the wrong routes if they're a wide receiver? Are quarterbacks throwing the ball the wrong direction? Those are key things you want to look out for," said athletic trainer Rob Bunger.
Bunger says athletes should break for water every 30 minutes to stay cool, and should monitor weight loss after practice.
"You might have one athlete that might lose one to two pounds and some athletes that may lose six pounds, and that's when it gets unsafe, especially when they don't rehydrate," Bunger said.
But even with constant supervision, heat related illness and sudden death are a possibility on the field.