Martin O'Neill has defended his decision to select Lee Cattermole after he picked up a knee injury during Tuesday's draw with Queens Park Rangers.
Cattermole's manager had hinted on Monday that he may play a part in the game, and the combative midfielder lasted only five minutes before having to be replaced by youngster Jack Colback.
Despite concerns over Cattermole's fitness prior to the game, O'Neill has defended his decision and confirmed that the latest injury is in fact a fresh one - affecting the player's other knee.
"It wasn't that much of a gamble starting with Lee," He said, "He was OK to play, and it was actually the other knee he hurt in a blocked challenge. That's a blow to us because he's still in a lot of pain from it.
"I feared, like most people, that it would be the same knee, but it wasn't. It was all part of a rather frustrating evening for us. It was tough for us losing Lee so early in the game.
"Even so it's a handicap you have to overcome, and it was just frustrating that we didn't really go on to find the form we've had in our last few games."
After playing out a scoreless draw against Harry Redknapp's side, Sunderland were left with just four wins from twenty seven attempts - with a trio of those victories coming against ten men.
Accordingly O'Neill admits he understands why fans feels edgy at present - with the Black Cats boss believing his side need to "tough out" the difficult winter period.
"The crowd gets edgy in games like these, and it's a sign of character for the players to come through it," he said.
"You have to play the ball you choose rather than the one the crowd want you to play.
"But that's not to blame the crowd - our crowd isn't the only one that would be getting anxious with the way we've been playing of late.
He went onto add: "The lads have said it was really tough last year too around about this time, and the matches played before Steve departed were particularly tough.
"I'm aware of that, and aware of the fact we need to get through this. We have to tough it out."