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BOWLING GREEN -- Like it or not, injuries are a way of life in athletics. Players sprain ankles, wrench knees, twist and strain and sometimes break parts of their bodies, forcing them out of action.
In recent years the number of coaches who suffer health issues on the sidelines seems to be on the rise, whether it's Minnesota football coach Jerry Kill suffering a seizure on the sidelines of a game this season, or Michigan State football coach Mark Dantonio suffering a mild heart attack one year earlier.
That issue hit close home when Bowling Green State University women's basketball coach Curt Miller suffered discomfort in the Falcons win over Eastern Michigan on Jan. 22.
"When the incident happened, I knew something was wrong," Miller said. "I had never had a migraine before, so the initial thinking was that it was an optical migraine.
"But after I returned from the [team's next game at Ball State] -- and we got home at 1 in the morning, and I had a meeting with my staff at 7 in the morning to prepare for practice at 9 -- then I went to the doctor and said, 'Something still doesn't seem right.'
"So they ran a few more tests, and suddenly I was ushered into a room and someone told me I had a stroke."
The diagnosis of a mild stroke was a shock to Miller, who is 43, doesn't drink or smoke, and works our regularly.
"Human nature makes you wonder, 'Did I just end my coaching career?' " Miller said.
It certainly doesn't have to be that way, and Miami men's basketball coach Charlie Coles is proof. He had a heart attack and triple-bypass surgery at age 43 while leading the Central Michigan program in the mid-1980s, then collapsed on the sidelines while leading Miami in a Mid-American Conference tournament game at Western Michigan in 1998.
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And at the end of the 2007-08 season, clogging of the arteries led to a quadruple bypass and installation of a new defibrillator.
Coles said the health issues have shaped the way he coaches now.
"After the first bypass, I knew I had to change my diet -- no red meat, nothing bad for me," said the former Central Catholic High School coach, now 70. "Second, I don't take work home with me any more. I don't watch tapes at home, I relax at home.
"Third, I do things that will help me be a better coach. Not necessarily new plays, but maybe things like having a better relationship with players and everyone around you: people like other coaches, the athletic director and the custodians.
"And here's something most people don't know: I only spend two minutes in the locker room after a game. Win, lose or draw; two minutes, and I'm gone."
The coaching lifestyle, which features around-the-clock attention to a program during the season, and extensive travel with offseason recruiting, can lead to health issues, said Dr. Cathy Cantor, one of the team physicians at BGSU who also is a ProMedica physician with a private practice at Wildwood Medical Center.
"A combination of all those things -- the hours, the travel, the pressure -- can lead to [health problems], with stress being No. 1," Dr. Cantor said. "It's like any executive who has to travel: It can lead to an unhealthy lifestyle, and that snowballs into other things."
University of Toledo men's basketball coach Tod Kowalczyk said meeting his wife and having a family were the best ways to combat those problems.
"I was a single, career coach who didn't get married until I was 40 years old -- and lived a very unhealthy lifestyle because of it," he said. "Once I became married, I saw that there's a lot more important things than wins and losses. It's helped me. Getting married to Julie and having children is by far the most healthy thing for me."
Coles agreed, adding, "Coaches fool themselves into thinking that 18-hour days are the answer. You have to use your time wisely, and if you don't you're in for a lot of trouble. I really think some coaches stress themselves out just hunting for things to do."
Dr. Cantor said coaches must treat the health risks of coaching in the same way an athlete would deal with an injury, which should include a focus on preventing a reoccurrence of the problems.
"When you look at an athlete's injury, you need to diagnose the injury," she said. "But you also have to diagnose the cause of the injury, whether it's biomechanical, diet, not enough sleep, overtraining or whatever.
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"In the same way, you can take steps to prevent this type of 'injury,' whether it's rest, diet, time management or managing stress. You have to take time and focus to managing those issues in the same way you want [injured] athletes to do."
Miller said he has taken those admonitions to heart.
"The doctors cleared me to coach again pretty quickly," he said. "I knew there were some things I needed to change, like the fervor that I coached. But I couldn't be afraid to be myself.
"The doctors equated it to an injury: I wasn't going to do any good for myself if I wasn't comfortable that the 'injury' was healed. I had some doubts; when you get diagnosed with a word like 'stroke,' you wonder if you will coach again this year, or if you will ever coach again.
"Medically, I knew I needed to make some lifestyle changes and changes in the way I coach. But it was only a matter of time because I felt I could give the team the energy they deserve."
One change Miller admits to is to tone down the animation -- the foot-stomping and jumping up and down -- that used to be part of his sideline persona.
"I have to get my point across differently," he said. "I was animated and demanding in practice [Wednesday], but there was a point in practice where we had three straight turnovers.
"In years past I may have blown a gasket. I would have lit them up verbally, and challenged them. This time, I just said, 'We are better than that.' There are times where I have to pick my battles.
"I'm still going to be explosive and demanding and animated -- at times. I just can't do that to the extent I have in the past."
The Falcons' senior captain, Jessica Slagle, said she and her teammates have noticed a difference.
"He's an intense guy, and he's very passionate about what he does, and there's no doubt that he loves the game," she said. "So you can tell it's hard for him to subdue himself a little bit.
"But it's very obvious he has tried to make changes, to try and reserve himself a little bit -- and tried to be the same coach he was. He challenges us every day, and he's not going to stop doing that just because he has to subdue himself a little bit."
It's a must if Miller -- or any other coach -- wants to remain on the sidelines.
"When it's all said and done they're not going to put on my gravestone a win-loss record," Kowalczyk said. "They're going to talk about me as a parent. That's much more important to me."
-- Blade sports writer Ryan Autullo contributed to this report.