The football world has been rocked by the serious injury sustained by Nottingham Forest’s Taiwo Awoniyi on Sunday.
The 27-year-old collided with a goalpost at speed when attempting to reach the ball and, after attempting to play on until the game finished, is now in hospital recovering after what his club described as “urgent surgery on a serious abdominal injury”.
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Awoniyi was also placed in an induced coma on Tuesday night following the surgery.
Here, The Athletic explains the circumstances around the incident, what an induced coma is, and what happens when a player is assessed by medical staff on the field.
What happened on the pitch?
When Forest winger Anthony Elanga was played in down the right flank, he was offside. However, referee Tony Harrington and his fellow officials allowed play to continue.
Shortly after, Awoniyi and Leicester City’s Facundo Buonanotte collided with the post as they launched themselves at Elanga’s resulting cross, with the Forest striker coming off worse. Buonanotte, through no fault of his own, followed behind Awoniyi, with his bodyweight appearing to increase the scale of the impact.
(Justin Tallis/AFP via Getty Images)
After three minutes of treatment on the pitch, Awoniyi was helped back to his feet after a few seconds in the 89th minute. After sitting down again briefly, he regained his feet for a second time and seemed to indicate that he would be OK.
The Forest bench interpreted Awoniyi’s gesture to mean he could continue and, as he made his way around the side of the pitch to wait to be allowed back on, they used their final substitution window to bring on Jota Silva for Elliot Anderson in the 91st minute.
How long did Awoniyi play on?
Awoniyi was not given permission to return to the pitch until almost the 92nd minute, when he was encouraged to get back into the action by head coach Nuno Espirito Santo, as referee Harrington waved the Nigerian back on.
He was allowed to return largely because of what Nuno referred to as a “miscommunication” between Forest’s coaching and medical staff when speaking in his post-game news conference.
Forest used their final substitute window to bring on Jota, believing Awoniyi was fine to continue.
Within a minute, however, and with the striker doubled up in pain, it was obvious he could not operate effectively. But with no more substitutes available, a largely immobile Awoniyi simply hobbled around the field for the remainder of the match, approximately seven further minutes of additional time.
He never broke into anything more than a trot, while frequently touching his stomach area in pain.
What happened afterwards?
When the final whistle blew, Awoniyi fell to his knees and had to be helped to walk slowly off the pitch and down the tunnel.
Meanwhile, Evangelos Marinakis, the Forest owner, made his way onto the pitch. Having initially seemed intent on walking past Nuno, who was talking to Leicester’s Oliver Skipp, Marinakis paused and exchanged some animated words with his head coach. The conversation only lasted a few seconds before Marinakis made his way back towards the tunnel, appearing to kick a cone in frustration on his way.
Later on Sunday, Marinakis released a statement saying he was “frustrated around the injury of Taiwo and the medical staff’s misjudgement on Taiwo’s ability to continue the game”.
(Justin Tallis/AFP via Getty Images)
On Monday night, Forest confirmed that Awoniyi needed surgery on the abdominal injury after further checks by the club’s medical staff revealed the issue required urgent treatment.
A club statement on Tuesday said Awoniyi was “recovering well so far, following urgent surgery on a serious abdominal injury”. That evening, Forest confirmed that he had been placed into an induced coma and was receiving intensive care following the surgery.
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Why was Awoniyi placed in an induced coma?
It is part of the medical process to repair the type of abdominal injury that Awoniyi suffered. Following surgery, he was placed in a coma as part of the recovery process. It is not a sign that his condition had deteriorated.
What is an induced coma?
A key stage in Awoniyi’s recovery. A medically induced coma serves as a means of regulating the heartbeat and protecting the brain of a patient after surgery. Anaesthetic drugs are administered in hospital, sending the person into a deep state of unconsciousness.
It is worth stressing that an induced coma is not always a sign of a patient’s deterioration, with the process considered more an integral part of recovery after undergoing surgery as serious as a ruptured intestine.
Brace up Tee 🙏Remember you’re stronger than you think 🦅🇳🇬 pic.twitter.com/4e3NBJm6ru
— 🇳🇬 Super Eagles (@NGSuperEagles) May 13, 2025
What is the process for an on-field assessment?
A club’s medical staff operate in challenging circumstances during the 90 minutes. They — typically a two-person on-field team — will need to make a quick assessment of the player’s condition in a limited period of time.
A head injury carries its own guidelines in the Premier League, given the threat of concussion, with a three-minute window afforded for treatment, but a medical team will often have to make difficult, detailed decisions quickly.
Common setbacks, such as muscle tears or ligament damage, will be easily detected by medics, but internal abdominal injuries, where the severity is potentially higher, would not be as easy to diagnose in an on-pitch setting. One English Football League physio, speaking on the grounds of anonymity to protect working relationships, told The Athletic it would be “nigh on impossible” to detect an internal abdominal injury in that time.
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Communication between the player and medical staff can carry huge importance. Once red flag assessments have been cleared, it becomes a delicate balancing act between the player’s wishes and best interests, where one can be to the detriment of the other. A player continuing will be warned of certain non-immediate symptoms and be asked to maintain communication once play was back underway.
There is also a belief within the English game that its sports doctors and medical staff are among the best trained in the world. The Advanced Trauma Medical Management in Football (ATMMiF) course, run by the Football Association at St George’s Park, has to be passed every three years for a physio to be able to conduct on-pitch assessment as a first responder, maintaining high standards across the Premier League and EFL.
A very modern thread of an on-pitch assessment in England’s top-flight is also the chance to consult their own video technology. That ensures a medical team member is provided with several camera angles on a tablet, with the capacity to review incidents that have led to injuries and help inform the on-pitch assessment.
Why did play continue if there was an offside?
The decision was made by Sian Massey-Ellis, one of the Premier League’s most accomplished assistant referees, not to flag Elanga offside, but that was only in keeping with protocols set by the International Football Association Board (IFAB) in the new world of Video Assistant Referee technology.
IFAB, the body responsible for the laws of the game, ruled in 2021 that a “very clear attacking situation” should see the assistant delay the flag and only intervene if the attacking team scores or retains possession of the ball through a free kick, corner or throw-in.
That effectively allows play to continue and not be halted by a potentially incorrect flag, but the Premier League’s own guidance says the offside flag can be raised if the assistant is “certain the attacker is clearly in an offside position and there is no risk of error”.
Massey-Ellis, it would seem, was not fully convinced that Elanga had strayed into an offside position beyond Leicester’s defence.
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How has the soccer world reacted?
On Tuesday afternoon, Forest released a lengthy statement on Awoniyi’s injury, wishing the player a speedy recovery and explaining the motivation behind Marinakis’ decision to make his way onto the pitch after the final whistle.
— Nottingham Forest (@NFFC) May 13, 2025
Union Berlin, Awoniyi’s former club, who Forest paid £17million ($22.6m) to sign him from in June 2022, also offered their best wishes, with a club spokesperson describing him as “a beautiful, gentle soul. We all just hope he gets better”.
Awoniyi grew up in Ilorin, in the state of Kwara, and the state governor, AbdulRahman AbdulRazaq, has released a statement on Instagram, wishing the striker well.
“Awoniyi is more than just a footballer — he is a proud son of Kwara State who continues to give back generously to the community that raised him,” he said. “His unwavering connection to home is inspiring and we look forward to seeing him return to the pitch stronger than ever. Get well soon, dear brother and valued citizen. Kwara stands with you.”
The former Manchester City and Newcastle United goalkeeper Shay Given, who had to undergo emergency surgery after suffering a tear in his bowel during a freak collision with West Ham United striker Marlon Harewood in 2006, also spoke to The Mirror about the similarities between his and Awoniyi’s injuries.
“When I heard how Awoniyi’s condition deteriorated, I started having flashbacks because it sounds like a very similar injury to the one I suffered,” Given said. “I just want to reach out because there is nothing more painful than what he’s going through.
“The specialist who operated on me said the only time he had seen an injury like it was after a car crash. He said it happens when you smash into something at high speed and your ribs hit the steering wheel.
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“Of course, I don’t know the full details of Taiwo’s injury, but it sounds very similar in terms of it being a result of a heavy impact. I’d just like to send my best wishes to him. I just hope he gets the same outcome that I did. It took me three or four months to recover, although I still have a big scar on my stomach as a permanent reminder that it could have been a lot, lot worse.”
(Top photo: Justin Tallis / AFP via Getty Images)
