For three weeks each spring, the nation is in a basketball frenzy as millions tune in to watch the NCAA March Madness tournament and follow their favorite teams. While Cinderella stories and coaching rivalries fight for headline space, one or two lines about a player’s injury could threaten to break a fan’s perfected bracket.

From the very first tipoff, 68 Division 1 teams set off on a marathon of athletics, similar to professional level scheduling, in hopes of still standing come April 6. To prepare for such high-intensity play with minimal time for rest, athletes must pay attention to each signal their bodies are sending, said Dr. Riley J. Williams, a specialist at Hospital for Special Surgery and head team physician for the New York Red Bulls and Iona College Athletics.

“It’s not the ideal circumstance for optimal performance, but having said that, the NBA does it all the time without obvious association with back-to-back games and injury,” Williams told FoxNews.com.

For the collegiate athlete who is forced to adjust to the national spotlight, possibly a different time zone, and a foreign arena, Williams said a key factor is adhering to a regular sleep pattern and getting plenty of rest.

“Not being able to get adequate rest in between games can have a dramatic effect on hand-eye coordination, strength and aerobic performance,” Williams told FoxNews.com.

Williams, who has worked with the Brooklyn Nets, said on a professional level when games are scheduled back to back, staffs execute some monitoring of output and minutes played per athlete to allow for regenerative work. Following a game, players typically shower and head directly to the athletic training room for a light massage and stretching of the upper and lower extremities. When available, players usually partake in contrast water therapy, which is transferring from a hot tub to an ice bath or cold tub. 

However, the type of therapy that a collegiate athlete receives typically depends on his or her school’s budget. A smaller school may not have the same resources as University of Kentucky or Duke University, and will rely on the basics for recovery like simple stretching and massage. Regardless of the budget, Williams said, all schools will be focused on their athletes’ time for recovery.  

Not allowing adequate time for the body to recover or skipping regenerative work may increase the risk of muscle strains and related injuries.

“If you are already pre-fatigued, you’re going to be prone to muscle injuries,” Williams told FoxNews.com. A player with even a slight injury in this type of high-intensity situation would be evaluated and have to be cleared to play to prevent further injury.

“They’ll need to make a very firm diagnosis and determine the degree of it,” Williams said of a potential injury, “if it’s playable or plan-on-able, and is it safe to play on.”

During a regular collegiate season, a player might be afforded a five-day period for recovery of even a slight tweak of a muscle or ankle. However, securing a ticket to the Big Dance sometimes means playing a game on only a single day’s rest between the previous games.

“With a compressed schedule, you simply don’t have time to get better,” Williams said, adding that if a player was truly injured the staff would not allow him on the court in the first place.

Williams said that at a certain point, players’ bodies get used to the conditioning required for the intense scheduling. He attributes this to why back-to-back scheduling in the NBA is not an injury-prone issue.

“They know what they need to do,” he said.

So far, the tournament’s most severe injury was Georgia State’s head coach Ron Hunter torn Achilles tendon, which occurred while celebrating his team’s victory over Georgia Southern.