By Karim Hammam
Former football manager Tony Pulis has warned that the relentless stress of the job poses serious health risks, urging current managers to prioritize their own fitness after a series of high-profile medical scares in the profession.
History of health crises in management
Pulis cited a long list of managers who have suffered severe health issues, from the death of Scotland manager Jock Stein after a 1985 World Cup qualifier to heart problems experienced by Graeme Souness, Sir Alex Ferguson, Gerard Houllier, Joe Kinnear and Harry Redknapp. He also recalled a 1999 experiment in which Leicester manager Dave Bassett and Bolton manager Sam Allardyce wore heart monitors during a match, with both reaching critical heart-rate levels.
Early career lessons
Pulis said his own self-management was poor when he took his first managerial role at Bournemouth in 1992. He described a diet of motorway fast food and half-time pies, combined with the pressure of being solely responsible for results. The stress intensified during poor runs of form, when criticism fell entirely on the manager.
Turning point and routine
A conversation with an Australian triathlete before leaving Bournemouth in 1994 prompted Pulis to change his lifestyle. He committed to early-morning workouts before breakfast at every subsequent club, a habit he maintained throughout his career. He also undertook endurance challenges including the London Marathon, a cycle from John O'Groats to Land's End, a climb of Mount Kilimanjaro and a row from Tower Bridge to the Eiffel Tower, which he said improved his sleep and stress management.
Mental health strategies
Pulis avoided reading press coverage, relied on trusted staff, and reserved Sundays entirely for family time, which he called a vital "release valve." He emphasized that switching off was essential for mental wellbeing.
Improved support structures
Pulis noted that clubs now offer better support, with the League Managers' Association running a "Fit To Manage" programme providing regular health testing, and medical staff extending care to coaching staff. He acknowledged that while the job remains lonely, the available help is far greater than at the start of his career.
