Players who lose consciousness in English top-flight matches next season will not be allowed to return to the field of play under new rules introduced by the Premier League and Football Association to limit the risks associated with head injuries.
Players who have not lost consciousness will still have to undergo an on-field or touchline assessment before being allowed to continue.
The FA has launched a campaign, backed by the Premier League, highlighting a set of guidelines that should be followed after a player suffers a head injury to ensure a safe return to action over a period of time.
Spurs were heavily criticised last season when their goalkeeper Hugo Lloris persuaded physios to allow him to continue at Goodison Park despite having lost consciousness.
There were also a number of high-profile incidents at the World Cup in which players continued to play on after similar knocks. In Uruguay's 2-1 win over England in the group stage, Álvaro Pereira described his injury as like the "lights going out" when Raheem Sterling's knee hit his head on 61 minutes. After arguing with the team physician, he was allowed to finish the game.
Germany's Christoph Kramer was also reintroduced to the game after taking a heavy blow to the head in the World Cup final. He was eventually replaced with referee Nicola Rizzoli saying after the match: "Shortly after the blow, Kramer came to me asking: 'Ref, is this the final?' "
There are serious risks involved with suffering a second impact if concussed and Dr Ian Beasley, the FA's chief medical officer, hopes managers and players in England can learn to understand when a player could be in danger. "Managers, players and clubs need to understand the risks associated with head injuries . . . and whilst we have developed processes to deal with many types of injury this is an area that has perhaps needed some more scrutiny.
“We are committed to working with Fifa to understand the universal impact of head injury in football. We will ensure that it is high on Fifa’s agenda and will be discussing options for a new research programme with Fifa.”
A campaign on head injury treatment, supported by the Premier League, Football League and League Manager’s Association, will be accompanied by an education programme in conjunction with the Professional Footballers’ Association.
England stars including Steven Gerrard, Leighton Baines and Rickie Lambert have contributed to a video produced by the FA.
Arsenal FC doctor Gary O’Driscoll, chairman of the Premier League doctors’ group, said: “With regard to head injuries there has been a perception in the past that you can tough it out . . . We need to make sure that everybody is aware of concussion, that everybody understands that it is just as significant as any other injury.”