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Injury update: West Ham United travel to Old Trafford minus several key players

Andy Carroll, Michail Antonio, Manuel Lanzini and Cheikhou Kouyaté will all miss the opening game of the season

Chelsea v West Ham United - Premier League Photo by Michael Regan/Getty Images

The real matches are back this weekend and West Ham United head for Old Trafford minus several players through injury.

Slaven Bilić has confirmed that Michail Antonio has still not fully recovered from his hamstring operation which took place towards the end of last season; and as such Michail is not considered fit enough to be involved in West Ham’s opening game of the season at Manchester United.

The coach’s other primary concern is over the fitness of Andy Carroll; who is continuing to work with the physiotherapy team in a bid to improve both his fitness levels and recuperate from the groin injury which caused him to miss so much of last season.

By all accounts Andy is reported to be working harder than ever as the new season approaches; but still remains short of the fitness levels required to turn out for the first team at the moment.

Arsenal v West Ham United - Premier League Photo by Shaun Botterill/Getty Images,

It's been documented that under West Ham’s new Head of Medical Services, Gary Lewin, Andy's present training regime is designed to push him to the limits.

This is the approach often taken when players have been struggling for a long time and is intended to test the injuries under conditions that will either provoke a reaction or identify the exact point where symptoms will flare.

There's absolutely no point in trying to protect any players carrying injuries that limit their participation in matches to the extent that their involvement with the squad is restricted to training sessions only in the hope that with time they will become symptom free.

The objective is to ascertain whether recovery is likely to be possible or if further investigation is going to be required. Under these circumstances the obvious consideration of potential surgery always in the back of your mind if the players involved are simply unable to progress past a certain level in training or rehab.

This would seem to be the stage that Andy is currently at. Although Slaven Bilić remains the eternal optimist, it might well be that Andy has just reached the stage where further sustained participation is looking unlikely without adopting a different approach.

The next few weeks will provide a clearer indication of how Gary Lewin et al are thinking. In the meantime, West Ham prepare for to face Manchester United in the opening game of the new league season minus not only Andy Carroll and Michail Antonio, but without Cheikhou Kouyaté as well.

Cheikhou returned to the squad in time for the pre-season following successful wrist surgery during the summer break only to sustain a knee injury in training that will see him miss the start of the new campaign as well.

These are obvious areas of concern for the West Ham coach and somewhat overshadows the signing of Chicharito and the other new faces, including Joe Hart, Pablo Zabaleta and Marko Arnautović.

It's not all bad news though. There is reported to be some light at the end of the tunnel with regards to Diafra Sakho.

The back condition which troubled him intermittently last season also involved surgery; but since Diafra has now turned out for the under 23s without any obvious adverse reactions being reported, this is positive at least.

Burnley v West Ham United - Premier League Photo by Ian MacNicol/Getty Images

Manuel Lanzini has also been out of action with a knee injury sustained recently and has spent the last two weeks working in the gym under the strict supervision of the medical team. Despite missing both game and training time as a result, his knee injury isn’t thought to be serious and the Argentinian should shortly return to the squad.

Other members of last season's surgical group who have all made successful recoveries from knee operations and are now back in the team include Angelo Ogbonna, Mark Noble and Winston Reid.

Pedro Obiang also had ankle surgery in the closing stages of last season following an injury sustained in March against Leicester City. This was reported at the time by West Ham’s then Head of Sports Science and Medicine, Stijn Vandenbrouck.

The Spanish midfielder has since made an exceptional return from injury and is now back in the team.

Good news at last for Slaven Bilić? Perhaps. But the fact remains that three of the current faces giving Slaven sleepless nights are all carrying injuries from last season into the present and he's definitely not going to be happy.

The obvious worries over those still recovering from their various operations only add to the uncertainty over whether the injury list will increase once the season proper gets going this weekend.

Gary Lewin and his team still have a lot of work ahead.