Football managers: Stress and health risks in the English Premier League

Apr 10, 14 Football managers: Stress and health risks in the English Premier League

INSIDE THE COTTAGE –  The Australian First Team Fitness Coach for Fulham Football Club, SCOTT MILLER gives an exclusive insight to the into the world of English Premier League football and how managers cope and deal with the stress of their high-pressured jobs.

It is a common theme in professional football where you hear of yet another manager’s job under threat due to their team’s current league position or persistent bad performances.

It is so common nowadays that a manager seemingly comes and goes and the scenario is constantly the same – he is sacked, his replacement is given the job to get the results on the board and improve the performances, a new manager comes in… And so the cycle goes.

The world of the professional football manger is one in which danger and uncertainty hang over every match the team plays. It is often a lonely and somewhat isolated position for a manager, which can leave many in the top job vulnerable to health risks, due to stress related issues.

I have worked for seven different managers during my time at the Fulham Football Club (Chris Coleman, Lawrie Sanchez, Roy Hodgson, Mark Hughes, Martin Jol, Rene meulensteen and current coach Felix Magath) and all of them have dealt with the demands and pressure of management in very different ways. Individually, their capacity to deal with success, defeat and player management issues have all be very different.


Scott Miller says - "In recent years various managers are developing health concerns and in one in particular is Gerard Houllier" - Picture by

Scott Miller says – “In recent years various managers are developing health concerns and one in particular is Gerard Houllier” – Picture by



The boss:
The manager is the main man; he determines the tone of the week in his body language, training structure, and simply how he wants the training ground environment to be.

In today’s professional football sphere – the manger’s role encompasses the players, the club owners, the fans and lastly, the media. Just imagine the pressure involved in controlling all of these factors. Each of these factors place different, and often conflicting, demands on the manager, all of which are equally important. So, as you could easily imagine, this creates an intensely pressurised working environment.


The ‘Houllier’ syndrome:
We have witnessed, in recent years, various managers developing health concerns and in particular Gerard Houllier provides proof that football management can be bad for your health. Houllier has been admitted to hospital on several occasions thanks to his position as manager of different football clubs. Famously, a decade ago when in charge of Liverpool FC,  the Frenchman underwent tests relating to his heart, and in worrying circumstances for his family and friends, underwent an 11 hour open heart surgery just to save his life.

Unfortunately, this is not new territory. Sam Allardyce, Graeme Souness and Joe Kinnear are among those who have suffered heart troubles related to the stress of football management.

The culture within a football club requires the manager to be strong and in control at all times, with no place for uncertainty or need for reassurance. The ego driven environment in which everyone is an expert, and the lack of control over one’s destiny as the players ultimately decide a manager’s fate through their performances – all contribute to possible stress related illness.


Each to their own:
As I mentioned above, all five of the mangers I have worked under have dealt with football related issues in different ways. I have seen players being pushed, verbally abused, bins thrown, kit skips being kicked, and I have even been used as a sounding board and copped an earful. Sitting in such close proximity to the manager, such as on the bench during a game, you really do get a feel for how they deal with the pressure. Some are worse at dealing with it than others, and it’s always interesting playing away from home and seeing how other managers deal with it. Sometimes it’s almost as if some managers are suffering from borderline Tourette’s syndrome and obscene language and mannerisms are not uncommon during periods of bad play from their team.


Scott Miller has now worked with 7 different managers while being fitness coach at Fulham FC - Picture by

Scott Miller has now worked with 7 different managers while being fitness coach at Fulham FC – Picture by



Gaffer alert:
These are all ways in which frustration can be shown, however, is it right for the players to see this side of the manager? I believe in certain instances it most certainly is, every athlete needs to be told when things are not going well, however I have found that the best managers always provide a solution – and although you may be on the end of some aggressive criticism – the solution is usually provided for you to improve your performance.

A manager’s mind must be a minefield – swaying from positives to negatives on an hourly basis, and generally the manager’s mindset is always dependent on the outcome of the most recent match. It is a somewhat humorous situation when reflecting on a defeat and how the manager behaves, noone really wants to be the person to cop the grief, so there is a common saying such as “gaffer alert” which signifies that it’s wisest if you become wallpaper, and don’t say or do anything that could tip him over the edge!


A delicate balance:
A mindset of ‘when you don’t win people don’t believe in you’ and ‘when you are winning you are never wrong’ all indicate a lack of stability and balance. When the team is winning, the manager is powerful; when losing or drawing, that false sense of security of short-lived success is dangerous, as the winning coaching philosophy suddenly comes into question.



Scott Miller and Fulham's Damien Duff

“Fulham fitness coach Scott Miller putting Damien Duff  through a warm-up” 


We understand that low self confidence impacts a player’s contribution to the game, however what impact does this have on the manager? The consequences are huge for managers. If the results are poor – the owner will still be the owner and the key decision maker; the players who have signed four year contracts worth millions will still be playing; the fans will still support the club – it is always the manager that will be bear the brunt. Sadly, in most cases, they are the cheapest to dispose of, and after all, it is their coaching philosophy determining the performances.


Who would be a manager?:
Managers live on a constant knife edge. The fortunes of a season can change for the better (or worse) in just three or four games. However, what is important is that the manager and the coaching staff absorb the pressure and allow the players to perform to their potential.

Of course, there are different ways of dealing with stress, however the manager’s overriding principle must be ‘what do I want my players to perceive me as? – a nervous wreck or someone they can look to on the touchline and gain confidence and belief from’. At the end of the day, this might just determine his future (and his health).

Scott Miller is an Aussie expat living in London and the First Team Fitness Coach for Fulham Football Club. Follow him on Twitter at @ScottGMiller


For full links to this article by Scott Miller in the please (CLICK HERE)

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