SUNDERLAND insist there was nothing sinister about Patrick van Aanholt’s late withdrawal from yesterday’s 1-0 defeat at Tottenham, but have continued to fail to clarify the exact nature of the “medical reasons” that resulted in the Dutch full-back being taken out of the starting line-up.

Van Aanholt was not involved at White Hart Lane despite having initially been named on the team sheet, and appeared to be unhappy when he learned of his exclusion prior to kick off.

David Moyes claimed there was a medical explanation for the move when he addressed the media in the immediate aftermath of his side’s defeat, but added, “I’m giving you what I think is the best answer just now”.

That led to a number of theories being aired on social media, with former Sunderland chairman Niall Quinn claiming on Sky Sports that van Aanholt could have been suffering from the after-effects of concussion following a late clash of heads in last Monday’s home defeat to Everton. These claims have, however, been denied.

The Black Cats have not issued a public statement on the situation, although privately, well-placed sources continue to insist that a medical issue is at the bottom of Sunday’s unusual events.

Within the club, there is a feeling that van Aanholt deserves to have his medical confidentiality protected, and at this stage, it remains unclear whether he will be available for Wednesday’s EFL Cup third-round game at QPR. Further clarity should arrive tomorrow morning, when Moyes conducts his scheduled pre-match press briefing.

Sunderland are adamant they did nothing wrong on Sunday, and there is no indication that either the Football Association or Premier League are unhappy at the way in which events unfolded. The Black Cats sought the correct permission to alter their team sheet around a quarter-of-an-hour before kick-off, and the match delegate present at White Hart Lane was satisfied with the explanation provided to him.