Mauricio Pochettino says he would never knowingly take a risk with Harry Kane's fitness, and that up to 30 members of staff are consulted before he selects a player, after Kevin De Bruyne's injury.
Manchester City's De Bruyne suffered a knee injury in training this week, having played until the last weekend of the World Cup with Belgium and then, less than a month later, featured in Manchester City's opening Premier League fixture at Arsenal.
Nine of Spurs' top internationals were also involved in the World Cup until the final or third-place play-off, with five of them starting on the opening day of the season, but Pochettino said they are taking care of his squad's fitness.
"We have our own truths about what we see and how we manage," he said. "We can't explain how we manage the players inside [the club].
"The people outside don't know if last week, after playing 90 minutes, Harry Kane was off on Sunday and Monday, or training or relaxing, or only did one training session, or was on the pitch or in the gym.
"Be sure that I am not going to take a risk. If we know we are going to take some conscious risk, it's sure he is not going to play.
"We have 25 or 30 people who are coaches, sport scientists, physios, and we talk a lot about fitness, health and everything. If we are wrong we are 25 or 30 people wrong.
"When we take a decision about health it is not a football decision. The responsibility is for Jesus [Perez], who coordinates everything, to tell me 'this player can play and it's not a risk.'
"But you know in football, it's always impossible [to avoid the risk completely]. The most fit players can get injured. Of course if this happens someone will [criticise]. But it's not easy.
"Taking decisions is always the most difficult thing. The easy thing is to give your opinion when the thing happens, or after the result."