It does not take much to end a World Cup dream, as Bolton Wanderers' Gary Cahill is finding out to his cost. Owen Coyle, his club manager, revealed yesterday that a blood clot has ended Cahill's hopes of further participation this season – and this summer.
Due to the scarcity of quality English-born central defenders – and because Rio Ferdinand's form and health has become the subject of consistent conjecture – the 24-year-old defender stood a fine chance of making Fabio Capello's 23-man squad for South Africa. Not anymore.
Cahill, who has easily been Bolton's finest player this season, felt discomfort in his left arm on Thursday night and it then swelled up so quickly, and worryingly, that he was ruled out of Saturday's match with Fulham on the morning of the game and taken to hospital. Doctors found a clot in his upper arm and admitted him that evening, giving him drugs to help dissolve the blockage.
Coyle said he had been in intensive care, underlining the severity of the situation. Because Coyle is concerned about the long-term effects he is not interested in using Cahill again this season.
His concern is that anti-clotting medication will undermine Cahill's chances of regaining full health and said that he did not want to risk the defender receiving a heavy cut in case it could not sufficiently heal.
"I think, given what I'm being led to believe regarding the medication and everything else, I will not be taking a risk with Gary Cahill's welfare and well-being," Coyle said. "I am maybe pre-empting things but I would be delighted if he comes back but I am not holding out much [hope].
"I thought that if he kept playing to the level that he was then he'd have been in the World Cup squad. Having seen the quality of players England have – and they do have quality in that position – then Gary wouldn't be out of place. There is no doubt about that but it looks as if that will now pass him by."
Tonight Bolton visit a Manchester City side still licking their wounds from a shock 2-1 loss at Hull on Saturday but City's manager, Roberto Mancini, has set his sights on third place despite his side's continued inconsistency.
City have now lost three of their last six matches, but Mancini is adamant that, even with games against Liverpool, Chelsea and Tottenham on the horizon, City can still make the most of their two games in hand.
"I am more confident," he said. "In my first three or four games we played very well but we had very few players available and I am confident that when I have all the squad available we can win at home and win away.
"You must remember that we have two games in hand. This is an important fact and if we win these two games we will be in fourth position and we will be one point behind Arsenal. We have to be really confident."
Mancini has complained that even though £250m has been spent on the squad he inherited, Mark Hughes left him short of midfield cover and, having failed to sign McDonald Mariga and Fernando Gago last month, that remains the case despite the capture of Patrick Vieira, who is set to make his first start for the club tonight.
"I know a lot of money has been spent," Mancini added. "This is a good squad but we have more players injured. It is strange that now we have only three central midfielders: Gareth [Barry], Nigel [De Jong] and Stephen [Ireland]. It is impossible to play a whole season with three central midfielders. Impossible."
Feast to famine: What's the problem with England's centre-halves?
Centre-half was until recently England's strongest position, but injury to the likes of Gary Cahill, loss of form and scandal have played havoc with the talent pool.
*John Terry Stripped of the England captaincy after his alleged affair with Vanessa Perroncel.
*Rio Ferdinand Terry's replacement has been plagued by back injuries, seeing him start only 10 games for his club this season.
*Matthew Upson Part of a defence that has leaked 40 goals already in 2009-10.
*Joleon Lescott Since his expensive transfer to Manchester City, he has spent two months out with injury and has struggled for form.
*Ledley King Hampered by a degenerative knee condition which prevents him from playing more than one game a week.
*Jonathan Woodgate Played just three games for Spurs this season. Out with a groin problem.
*Phil Jagielka A ruptured cruciate ligament put the Everton man's career on hold last April. Unlikely to return before the end of March.
*Wes Brown The 30-year-old's career has been littered with knocks and niggles, but he is currently on an injury-free run after returning from a hamstring strain.