Fabio Capello's World Cup preparations were dealt a severe blow last night when it emerged that Gareth Barry, his last available specialist holding midfielder was set to miss the tournament.
Barry, 29, was told yesterday that he will need at least three weeks recovery from damage to his right ankle sustained against Tottenham on Wednesday night.
That takes the midfielder right up to the start of June when Capello has to name his 23-man squad and the England manager is already making preparations to cope with Barry's absence.
Barry has been a mainstay of Capello's England team and potential replacements are notably thin on the ground. Manchester United's Owen Hargreaves has only made one substitute appearance in 18 months, meaning it is likely that West Ham's Scott Parker will be named in the provisional 30-man squad on Tuesday.
Tottenham's Tom Huddlestone is another possibility or Capello may decide that Steven Gerrard is best suited to a more defensive role. The scan revealed the extent of the damage to Barry and Capello has already said this week that he cannot afford to take players who are still recovering from injury.
Barry established himself under Steve McClaren and has been a fixture in Capello's teams since the Italian took over in February 2008. Filling that holding midfield role presents major problems for Capello, who can hardly rely upon Hargreaves, who been battling against tendonitisin a knee since September 2008.
Missing the World Cup will be a considerable blow to Barry, who was continually overlooked by Sven Goran Eriksson when he was England manager and only came into regular contention when the Swede departed after the last tournament four years ago.
The manager has considerable injury worries, with fears over at least 11 of the players who are contenders for his squad as well as Barry.
The Tottenham captain, Ledley King, is now a certainty to be named in the 30-man squad for the World Cup finals after he came through two games in five days for his club side, culminating with Spurs' win at City on Wednesday.
Capello and his assistants have long been admirers of the 29-year-old, who is still yet to play a game for the England manager because of the chronic knee problems he suffers. They have been willing to explore any avenue to get King into the England squad, although the fear has always been that he would be unable to stand up to the rigours of tournament football.
However, that King came through Saturday's game against Bolton and Wednesday night's win at Eastlands was all the evidence Capello and his staff required that despite his problems, King could play at a World Cup. He is still not sure of a place in the final 23-man squad, especially with Rio Ferdinand also such a major injury worry, but he will be part of the squad for the pre-tournament friendlies against Mexico and Japan.
Tottenham's medical staff had previously claimed that King, who is unable to take part in training during the week because of the swelling to his knees that playing games engenders, was only capable of playing after six days' rest. The events of the last week would appear to suggest that, at a push, he can play more regularly than that.
There will be concerns at Tottenham about the potential effects on King should he play a World Cup with England. The club has bad memories of his last summer outing for England against Estonia in 2007 when he subsequently missed six months of the domestic season with complications the club believed were made worse by his international service.
King's team-mate Peter Crouch, who grew up alongside the Spurs captain as a youth team player at the club, said that a fit King was a "shoo-in" for the England team. Crouch said: "I've played with him since we were 12. He was always the best in youth team, schoolboys. He's a phenomenal player. He doesn't train ever, but then he comes in and he's our best player – man of the match [against City].
"If he can be fit, he's a shoo-in for the World Cup. If he can prove his fitness, there are not many better than him."
There is still an outside hope that the Capello camp may be able to talk Jamie Carragher out of his international retirement, three years after he announced his withdrawal from England, although that is still a long shot. What makes the Liverpool defender so valuable is that he is capable of playing right-back as well as his favoured position of centre-half.
There is a slight worry over the fitness of Aaron Lennon, who appeared to be limping when he left the pitch on Wednesday night. Lennon, who was substituted in the 71st minute, is only three games into his comeback after a four-month long absence with a groin problem.
Having advanced his claim for a place in Capello's England starting XI, Crouch said that Tottenham fully deserved their place among England's elite in the Champions League next season. He said: "When I first came in, I said 'How on earth are we not challenging for things?' When we've got international players out of the side, we've got international players to replace them. We've got a lot of young players, fantastic talent. It's only going to get better, and it's a really exciting time to be part of Tottenham.
"We'll be going all out to finish strongly at Burnley and get a result, and see what happens. I've got to be honest, we didn't dream about catching Arsenal. They were challenging for the title at one point, and we were never in the title race. But it is a possibility and that would be fantastic, the icing on the cake. We just want to get a result at Burnley and finish the season well.