Football players ram into each other to begin a play and usually end it with a collision that brings a ball carrier to the ground.

Hockey players pin each other against the boards with body checks and use any physical means necessary to separate an opponent from the puck.

Wrestlers square off inches apart, then almost immediately grab arms, bump heads and exert themselves in face-to-face contact, often breathing the same air for six minutes or more.

Throughout the COVID-19 pandemic, public health officials have stressed social distancing to combat the deadly virus, which is largely spread through infected droplets from coughing, sneezing and talking. But for contact sports, social distancing isn’t a workable option.

As football, hockey and wrestling move ahead toward restarting, those involved are working to keep coronavirus cases to a minimum, hoping to avoid a pause in play or another shutdown. And the margins are razor-thin for these sports, given how close the competitors are when they square off.

“With it being an airborne illness, there’s effort and exertion, and spit and droplets will be projected through that,” said Troy Hoehn, a supervisor athletic trainer for the Mayo Clinic Health System and past president of the Minnesota Athletic Trainers’ Association. “That’s where the difficulty comes in those sports where you’ve got people that are really close together for an extended period of time.”

Last week, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cast doubt on football returning in 2020 without having all teams report to one solitary location.

“Unless players are essentially in a bubble — insulated from the community and they are tested every day — it would be very hard to see how football is able to be played this fall,” Fauci told CNN. “If there is a second wave, which is certainly a possibility and which could be complicated by the predictable flu season, football may not happen this year.”

In Minnesota for youth and adult sports, the state health department has labeled football, hockey and wrestling among the “higher-risk” sports. Baseball, basketball and soccer are among the “moderate-risk” sports. “Lower-risk” sports include running, golf and singles tennis.

On Friday, the Minnesota Department of Health announced outdoor sports can begin games and scrimmages on Wednesday, while indoor sports can return to full team practices on Wednesday and games on July 1.

“A lot of parents, a lot of coaches, a lot of kids are waiting. ‘What does our new normal look like?’ ” said Hoehn, who works extensively with prep and youth sports. “We all know it’s going to be different.”

Following football’s lead

College football, the driving revenue force for most athletic departments, already has seen setbacks as players return for voluntary workouts. Sports Illustrated reported that 30 of Louisiana State’s 115 players have been quarantined because they either tested positive for COVID-19 or had contact with those who tested positive. At Clemson, 23 football players have tested positive.

Fauci told in May that football is the “perfect setup” to spread COVID-19 because of the close contact between players.

Dr. Patrick Smith, who spent more than three decades as Gophers football team physician, sees returning to play as challenging but necessary.

“In college football, the rosters are 85-plus, and you’ve got issues,” Smith said. “Testing is essential, and screening is essential. It’s got to be very efficient, meaning you’d like it to come back within 24 to 48 hours at a minimum and certainly with testing that has very few false negatives. … Those are the ones you can’t miss.”

Gophers football players began returning to campus earlier in June for voluntary workouts, but first came an extensive coronavirus testing and screening plan.

“It’s time to decide how we’re going to live with this virus,” said Smith, who retired this year. “… Keeping yourself locked up in a cocoon is not wise. It’s not science.”

St. Thomas football coach Glenn Caruso expects the Tommies’ preseason camp to start in the second week of August as usual but acknowledged there likely will be changes in how teams operate in hopes of practicing social distancing.

“We have to be able to maybe have less numbers at practice, maybe different spacing at practice,” he said. “And it’s not just practice — it’s treatment, the training room, the locker room. The one thing I’m positive of is things are going to be different.”

Caruso is encouraged by the planning that’s happened over the past three months.

“What keeps me sleeping at night and having a little peace in my heart is having the confidence and knowing the powers that be are not taking any precaution lightly,” Caruso said.

NHL inching closer

The NHL is moving toward resuming its season, with the start of training camps set to begin July 10 if medical and safety conditions allow. The playoffs, involving 24 teams, would start in early August at two hub cities.

Wild General Manager Bill Guerin, whose club is slated to face the Vancouver Canucks in a best-of-five preliminary round, puts confidence in the league’s protocols, which includes daily coronavirus testing.

“What the league and us as individual teams have been extremely diligent on is making sure we have the right procedures where we can keep everybody involved safe,” Guerin said. “We would only do this if we could do that. We’re not going to do this just for the sake of doing it and put people in harm’s way.”

The NHL announced Friday that 11 players have tested positive. Three players and additional staff members of the Tampa Bay Lighting were among the positive tests, and the team shut down its training facilities.

It will be interesting to see how the NHL handles the on-ice social distancing aspect of the sport. Playoff hockey, charged with intensity, often includes scrums with plenty of face-to-face conflicts. In one extreme episode two years ago, the Boston Bruins’ Brad Marchand licked Tampa Bay’s Ryan Callahan under his nose, behavior that in 2020 could lead to a COVID-19 infection.

Dr. Shmuel Shoham, an infectious disease expert at Johns Hopkins University, is encouraged by the NHL’s plan for two hub cities and emphasis on frequent testing. He said for any sport, staying disciplined is the key.

“Monitor for symptoms all the time,” he said, “and if anyone turns positive, pounce on that.”

Wrestling with reality

Ask if social distancing can happen during a wrestling match, and Jim Moulsoff has a quick one-liner.

“No, that’s stalling,” Augsburg’s co-head coach said of the passive, clock-draining tactic that can lead to wrestlers being penalized.

Wrestling, it could be argued, involves the closest contact of any sport. The U.S. Olympic and Paralympic Committee in April included wrestling among sports with a “high risk” of disease transmission in its return-to-competition guidelines, pointing to “close, sustained contact between participants, lack of significant protective barriers, and high probability that respiratory particles will be transmitted between participants.”

According to the Wall Street Journal, USA Wrestling criticized that designation, arguing that data didn’t support that distinction. This led to some changes in labeling, with “Level I” replacing “high risk.”

Events such as the USA Wrestling Junior Nationals, which drew more than 5,000 competitors to Fargo last July, have been canceled.

Moulsoff, who has led Augsburg to three NCAA Division III titles, emphasized that wrestlers are prepared to deal with coronavirus protocols because they are constantly monitoring their weight and guarding against skin infections.

“Adding one more thing really isn’t going to faze them,” he said. “They’re always willing to adapt, whatever it takes, so they can get on the mat.”

Hoehn, the athletic trainer with Mayo Health Systems, said “it’s naive to think [sports] won’t start back up.”

“But we also have to be prepared for the fact that if we start to see a significant amount of issues or a significant amount of teams or groups that come down with COVID, we’re going to see things close to shut back down,” he said. “There’s really no way to know that.”