So busy looking after others, they don't look after themselves

Are managers fit to manage? Andrew Longmore hears a specialist's diagnosis

Bill Parcells, one of the great American football coaches, once delivered the definitive description of the touchline fanatic. Parcells was an American Alex Ferguson, a brilliant motivator and a volatile character, never happier than when bawling out a referee or his own quarterback. Asked once to explain a spectacularly explosive outburst, Parcells' response was simplicity itself. "This is not," he said, "a profession for well-adjusted people." In other words, do not judge us on the basis of normal behaviour.

The image of the frustrated coach is pitched into our living room almost every night of the week, the lonely figure acting as lightning conductor for thousand-volt passions. The fans see a man to acclaim or blame. Dr Dorian Dugmore, director of the Adidas Wellness Centre in Stockport, sees an X-ray of a human being under the severest stress. He sees increased heart rate, pumping adrenalin, narrowing arteries, a rush of cholesterol and the drawn, white, contorted face of an executive trying to control the uncontrollable.

Dugmore is an expert in cardiovascular medicine. He is also a fully qualified football coach, which makes his dissection of the football manager's way of life particularly relevant. He has been there himself, in his own minor way, as coach of the Great Britain students side in the early Eighties. "We played against Argentina in a tournament in Zagreb, not long after the Falklands War," he recalls. "There was a huge, volatile crowd and we were awarded a disputed penalty minutes before the end. We went ahead and all sorts of things were going on. I thought, 'This is what these guys go through'. I was absolutely knackered by the end of it. A manager goes through that twice a week."

It is easy enough in the wake of Gérard Houllier's heart surgery to reflect on the casual attention paid to the health of football man-agers. Under the auspices of the League Managers' Association, Dr Dugmore and his team in Stockport have been working for the past year on a pilot scheme tailored to the peculiar demands of football management. Ten managers, including Sam Allardyce of Bolton Wanderers, have so far been monitored under the "Fit to Manage" prog-ramme. The ambition of Dugmore and the LMA is that every manager in the League will eventually benefit, given extra funding or sponsorship.

"It's hard to say whether Gérard Houllier's illness could have been avoided," explains Dr Dugmore. "All I can say is that we have the potential to spot it." There are three main areas of the "Fit to Manage" programme: lifestyle assessment, risk profiling and stress factors. Managers are initially tested for blood pressure, body composition, flexibility, heart and lung capacity and for their ability to cope with different levels of stress. "You can blow a gasket and people say, 'He's bound to have a heart attack sooner or later', but maybe it's the one who bottles it up who is more vulnerable," says Dugmore. "There is no way you can generalise about stress. Everyone is different. What we can do is make managers realise what is going on and to face up to the stresses in their life. Like the top executives in the corporate world, these are intense, driven guys. They're ambitious, they're tenacious, they're obsessive, they don't take holidays. They are the chief executives of the football world and often they are so busy looking after everyone else, they don't look after themselves."

A matter of time more than inclination. Once he had started on the road to recovery after his own heart attack, Joe Kinnear, former manager of Wimbledon now at Luton Town, gave a graphic account of a way of life heading deep into cardiac country. Late nights, long drives, irregular dietary habits, fast food, too little time, too much weight. And every Saturday the ultimate one-way ticket to despair or elation. Kinnear instinctively understood the terrain, but doing something about it?

Part of Dugmore's prob-lem is catching the attention of a manager with higher priorities. "When you talk to them, they feel neglected – maybe that's not quite the right word – but on their own. It is a lonely job and the beauty of our lifestyle programme is they feel someone is at last looking after them. We have a girl who comes into the office once a week, whose sole job is to ring around these guys and find out how they're doing with their programme."

Managers are monitored every month, brought back for assessment at the Well-ness Centre every six months and, again, for a final debrief at the end of the year. "The most important thing is that if there is anything untoward in their condition, we can point that out." But Dugmore firmly believes the clubs themselves should take greater care of their assets. "If you've got a car and you drive 100 miles up and down the motorway every day, you make damn sure that the car is in good shape, don't you? In a sense, you've got a Rolls Royce in a manager."

Or a Robin Reliant. Fifteen managers have been sacked this season already. Four years ago at the same stage the number was four. Pressures are increasing by the day, not just for Premier League managers. Out of the batch of 10 already subject to research, Dugmore estimated a third were very fit, a third were in the middle and the rest needed to look at the way they lived. The next stage of the project involves monitoring managers when they are at work, on the touchline wired up. "That will really tell us what is going on," says Dugmore.

Managers already know, of course. The one true relief for stress is victory.