Why Leeds United's Robin Koch is allowed to face Tottenham Hotspur - concussion rule explained

Scott McTominay's first half challenge left the German defender with a gaping wound above his eye and although Koch initially passed the Premier League concussion protocols and returned to the game, he succumbed to the effects before half-time and had to be withdrawn.

According to the FA guidance on concussion their graduated return to play protocol should be followed in all cases, with an initial rest period of 14 days unless a player is in an 'enhanced care setting' and aged over 19.

The guidance says: "Professional and elite level players sometimes have access to an enhanced level of medical care which means that their concussion and their return to play can be managed in a more closely monitored way. In this situation only, the guidelines for return to play in an enhanced care setting may be followed."

Leeds have at their Thorp Arch training base a club doctor - Rishi Dhand - and a head of medicine and performance - Rob Price - to oversee the protocols and rule over Koch's suitability for a return, which helps qualify players for an enhanced care setting.

A club must also hold baseline information on the player's brain function from testing completed before the injury was sustained, and formally document an assessment of a player's cognitive function, emotional wellbeing, neurological function and any physical trauma sustained. A player must also have access to neuropsychology, neurology, neurosurgery specialists and other clinicians as required if their progression under the protocols is not.

Finally, clubs have to put in place a formal and documented concussion education programme for coaches and players.

Stage two of the graduated return to play protocol can only begin 24 hours after day zero - the day of the injury - if a player is symptom free, so by Tuesday, when Marcelo Bielsa confirmed Koch's condition was perfect, he was able to partake in 15 minutes of stationary cycling having had 36 around hours rest. Before that, however, he will have undergone neurocognitive tests and had the results compared the baseline data Leeds had previously captured.

On Wednesday, alongside further tests, Koch will have been able to do football-specific exercise and by Thursday he was permitted to do non-contact training. Day five, which is today, is when Koch can return to full training but only after being cleared to do so by Dhand.

Day six, Saturday, is the earliest point at which Koch can be involved in a game, but the YEP understands he will only do so having undergone further neurocognitive tests and had the clearance from the club doctor.