Tottenham injury blow as Lucas Bergvall fumes after early substitution against Chelsea | OneFootball

Spurs midfielder replaced in opening stages of London derby after blow to the head

The painful blow knocked a clearly dazed Bergvall off balance as he stumbled initially before then falling to the ground.

The Swedish international returned to his feet but was holding the side of his head as he continued to walk around in unstable fashion.

Tottenham’s medical personnel quickly assessed Bergvall and felt that he needed to be replaced after carrying out the necessary examinations in a delay to the game, much to the player’s annoyance.

The 19-year-old seemed to argue with Spurs’ medical staff both on the pitch and on the sidelines as they made their decision and appeared to twice push away the arm of the club doctor as Bergvall unsuccessfully tried to appeal to Tottenham boss Thomas Frank to be allowed back into the fray.

However, Frank opted to send on summer signing Xavi Simons in his place as a furious Bergvall then went straight down the tunnel and Tottenham’s medical staff were praised for their decisive action.

That went down as a concussion substitution, with current Premier League rules allowing the use of one such replacement per team, per match if needed.

A concussion substitute does not count towards the five regular substitutions allowed in a Premier League game and can be used even when all of those allotted five changes have already been made.

One team’s use of a concussion substitute also allows the opposition the use of an additional substitution, which can be deployed for any reason.

After losing Bergvall so early, Tottenham were also handed a first-half injury scare over Guglielmo Vicario against Chelsea as the goalkeeper went down and received treatment before proving himself fit to continue and providing the lone bright spark in a 1-0 loss sealed by Joao Pedro’s first-half effort.

Spurs got captain Cristian Romero, Destiny Udogie and Wilson Odobert back from injury on Saturday night as all three players appeared off the bench in the second half, though Dominic Solanke, Dejan Kulusevski, Archie Gray, Ben Davies, Yves Bissouma, Radu Dragusin, Kota Takai and James Maddison all remain sidelined.