Heart attacks, pills and no sleep - the manager's life under pressure

"Your arms go a bit numb at first," said Barry Fry yesterday, explaining what it felt like during his two heart attacks. "Then it's like there's a knife being stuck in your chest, and twisted. Then it feels like someone's poured a bucket of tepid water on your head because there's so much sweat. It's horrible, a total panic.

"Your arms go a bit numb at first," said Barry Fry yesterday, explaining what it felt like during his two heart attacks. "Then it's like there's a knife being stuck in your chest, and twisted. Then it feels like someone's poured a bucket of tepid water on your head because there's so much sweat. It's horrible, a total panic.

"If you've got a collar and tie on you just want to rip it off from round your neck and get to hospital," he continued. "The second time, I went to Papworth. I was lying in a ward and there were people dying either side of me. And I'm lying there thinking 'What the hell am I doing here?'

"Even when you've recovered it can stay with you. You get bad indigestion and you're thinking 'Is this another one?' It's frightening."

Fry's first heart attack struck 13 years ago as he was pushing a broken-down Barnet team bus at Gateshead. His second came in 1996, shortly after he took over at Peterborough, where he is now the owner-manager.

Though he bounced back from both heart attacks, Fry says they were "terrifying", and that football management today is never conducive to a relaxing life. He agrees with the vast majority of managers who think their work is much tougher today than 10 years ago.

Managers across all divisions, consulted by The Independent, talk of increasing pressures on health and family life. Southampton's Harry Redknapp has trouble sleeping, and said earlier this year how he would wake early after fitful rest with chest and stomach pains. "In this relegation battle there's nothing in your mind but getting safe," he added recently. "Every minute, every day. Even when you're at home, you're not there mentally."

The major single factor that makes management tougher today is the relentless pressure of being under scrutiny, according to 38 per cent of managers. This is followed by the prevalence and influence of agents (27 per cent), and high-earning players who have too little respect (20 per cent). Other managers cited reasons as varied as "weak directors who make decisions to take pressure off themselves", "no time to develop a club or playing strategies because winning is everything" and "lack of patience from the board".

Fry believes his heart attacks are related to a medical condition linked to the blood clots that prematurely ended his playing career. But, he added that "the demands and pressure of management are unbelievable".

"For the last 13 years I've taken four tablets a day [for my condition] and I now get a check-up once a year. It is a very stressful job. The media alone is ridiculous. It used to be one press conference a week, now it's one a day. Radio stations want to talk, there's TV, websites hammer you to death. Radio phone-ins start two minutes after the final whistle asking whether the manager should go. And I get dog's abuse every match in the dug-out. And that's just from our own fans!

"It's draining, mentally and physically. As a profession it can be full of pressure, loneliness and stress."

Surely after his second heart attack he considered giving up and doing something else? "To be honest, I didn't. Even in hospital I thought 'I'm doing the job I love'. There are lots and lots of lows in this game, but you're in it for the highs, rare as they are.

"I know I've got to look after my health. I was supposed to have a double hip operation last summer but didn't have the time. But I'll get it done You need your health in this job."

Terry Dolan, the former manager of Bradford, Rochdale and Hull, believed himself to be in good health when he went for a check-up at Dr Dorian Dugmore's specialist clinic in 2002, when managing York. Dolan had run the London marathon in 1999, aged 49, but during a walking test on the treadmill, Dugmore suddenly stopped the test.

"I said 'What have you stopped for?'" Dolan said yesterday. "They said 'We need to'. I said 'Why?'. They said 'Your heart rate is 235bpm. If it's like that on a regular basis, you could be in big trouble.'"

Dolan was diagnosed with atrial flutter, the same condition famously suffered by Alex Ferguson, who had a pacemaker fitted, and Tony Blair, who had shock treatment to correct it, as did Dolan. Dolan still follows Dugmore's "Fit to Manage" health programme, where the mantra is: "An ounce of prevention is worth a ton of treatment."

The Independent's managers' survey indicate stresses from all aspects of management, ranging from frustration at the transfer window (82 per cent are against) to raging at perceived timing errors by referees, as Everton's David Moyes did last weekend. Less than half of managers want the referee to be the time-keeper.

Leeds' Kevin Blackwell says: "There's always something - transfers, injuries, players' contracts, the media, players' problems.

"It's rare for me to be able to sit down and watch television at home with my family. The job doesn't allow that. The phone never stops.

"Sometimes I get back in at 1am, and then there are even calls in the middle of the night from abroad," Blackwell admits. "But I don't worry about the stress. I've enough to worry about with the job."

Brentford's Martin Allen, who is married with four children, aged 11 to 16, added: "It takes over your life and has a massive effect on your family. It is all you think about.

"I had a night in a couple of weeks ago and my wife was watching Eastenders. Dirty Den appeared and I said 'Is he still in it?' I didn't know he'd come back. [And doesn't yet realise he's gone again].

"The family are asking what are we doing for Easter," Allen says. "The answer for me is taking training and playing matches at Wrexham on Friday and at home on Monday.

"Is it worth it? You have to pay the bills. Being a player is like having a tree at the end of the garden with gold coins on it. Then when you get to 32, 34, someone chops it down. Suddenly you're in the wide world with 30 working years left. What are you going to do?

"Through managing and coaching I have the opportunity to have another career."

Chester's Ian Rush sums up attitudes in general. He thinks six-day weeks and three weeks off each summer are a recipe for adequately recharging your batteries. "The one time I had a winter break, when I was a Juventus player, I came home and trained with Liverpool and watched games."

Additional reporting: Glenn Moore and Jason Burt