Tottenham manager Andre Villas-Boas decision to keep goalkeeper Hugo Lloris on the pitch after taking a heavy blow to his head was both “dangerous and irresponsible” which also put his long-term health at risk.
That is the view of Headway, a brain injury charity that has slammed the Spurs’ boss for choosing not to bring off the French shot-stopper after he collided with Everton striker Romelu Lukaku in the 78th minute of their 0-0 Premier League encounter on Sunday.
With replacement goalkeeper Brad Friedel ready to come on, and a visibly hurt Lloris taken towards the sidelines, Villas-Boas quickly sent the American back to the bench once it seemed Lloris could continue, despite remaining wobbly on his feet having spent a lengthy period receiving treatment from the Spurs medical staff.
"We are hugely concerned that a professional football club should take such an irresponsible and cavalier attitude to a player's health," said Luke Griggs, spokesperson for Headway.
"When a player - or any individual - suffers a blow to the head that is severe enough for them to lose consciousness, it is vital they urgently seek appropriate medical attention. A physio or doctor treating a player on pitch simply cannot accurately gauge the severity of the damage caused to the player's brain in such a setting as there may be delayed presentation of symptoms.
"By continuing to play, the player may have caused greater damage to his brain. He should have been removed from the game immediately and taken to hospital for thorough tests and observation."
In a post-match interview nearly an hour after the incident, Villas-Boas admitted that Lloris still couldn’t remember the moment that Lukaku’s thigh struck him on the side of the head, but immediately defended his decision to keep the 26-year-old on the pitch. The Portuguese cited a good save from Everton substitute Gerard Deulofeu as vindication of his choice not to send Friedel on.
But Headway stressed that the dangers of a head trauma is a serious risk and one that should not draw praise for bravery if someone plays on.
"Guidelines from both Headway and the National Institute for Health and Care Excellence (NICE) state people should not play any contact sport for at least three weeks after suffering a concussion," Griggs added.
"Sports science has evolved significantly over the past decade and yet we're still faced with the antiquated concept that a player should be brave and try to continue at all costs.
"Mr Villas-Boas' comment that his player's determination to play on was proof of his 'great character and personality' is simply wrong and dangerous.
"You are not a hero if you play on after suffering a concussion; all you are doing is risking your health. Football has to react to this and bring in stricter measures to ensure no similar risks are taken in the future."
While concussions aren’t an unknown commodity in football, it is a very common injury in both codes of rugby as well as American football, with both sports having taken measures to prevent head injuries in recent times.
Dr Barry O’Driscoll, uncle of Irish rugby great Brian O’Driscoll, resigned from his role as medical advisor to the International Rugby Board over his opposition to new protocol’s being brought into the game to address the situation.
All players are now required to undergo a five minute concussion test following any blow to the head, although recent sights of both Dr O’Driscoll’s nephew and Australian flanker George Smith returning to the pitch after visibly suffering a head injury saw these measures come under serious scrutiny.
The Rugby Football Union is so concerned about concussion that it is holding a conference at Twickenham later this week with players' unions after further cases.
In August, Leicester Tigers and England fly-half Toby Flood had to be taken to hospital after being knocked unconscious in a pre-season game against Ulster. It was the second time in just over three months that he had been knocked out on the pitch.
Australia's National Rugby League recently adopted the NICE and Headway protocols on concussion, advising that players who suffer concussion be immediately withdrawn and be given adequate time to recover before playing again.
Other recent cases include Arsenal’s Mathieu Flamini, Norwich’s Robert Snodgrass and Lukaku himself have already suffered from concussion this season, with the Belgian striker admitting he could not remember scoring the match-winning header against West Ham on his Toffees debut.