On top of the recent spate of ankle injuries at West Ham United, it appears that the old issue of hamstring muscle strains takes precedence this week as the Hammers prepare to face a tough game at Wigan Athletic in the F.A. Cup.
Manuel Lanzini, Marco Arnautović and youngster Nathan Holland are all unavailable for the East London side following recent hamstring injuries. Although in most cases these injuries are largely unavoidable, that’s no consolation if you happen to be one of the players concerned.
Even less so in Nathan’s case, where the injury required surgery; and that’s a fate also suffered by Michail Antonio last season when an operation was deemed unavoidable following a recurrence of an earlier hamstring tear a few weeks beforehand.
And based on recent reports its particularly disappointing to find that Manuel Lanzini also looks to be out of the team for some considerable time for the same reason.
Hamstring injuries, as we know, are extremely common in football. But it should be emphasised of course that hamstring muscle problems aren’t only confined to West Ham United.
As the television marketing people would say, similar injuries are available at other clubs as well.
It doesn’t make the situation any easier though. David Moyes is already without Edimilson Fernandes, Andy Carroll and Jose Fonté as a result of the ankle problems which we spoke about in earlier columns and were never expected to be in contention for the trip to Wigan.
As suspected, Andy Carroll’s injury also went to the operative stage so he’s going to be out of action for a while.
Irrespective of whether you're an Andy Carroll fan or not, it doesn't change the fact that David Moyes now has one less striking option to consider as the season reaches a vitally important stage.
Michael Antonio and Winston Reid - although currently recovering from thigh / groin injuries and reported to be not too far off making a return - are highly unlikely to be in contention for a place for several days yet.
And in Michail’s situation, the chances remain that he might still end up undergoing further surgery if regular treatment fails to satisfactorily resolve the problem.
It’s been discussed lately in the media - and confirmed by David Moyes himself - that the option of surgery still remains a possibility for Michail if the signs are there in a week or two that making a full recovery is going to be lengthy and complicated.
With groin and hamstring strains often linked in terms of recovery and susceptibility to injury in the first place, Michail in particular hasn’t had his troubles to seek.
After recovering from one injury, his return earlier in the season was complicated by a totally unconnected rib injury; but its often the case that one injury can result in another and that always seems to happen just as you get back into the team.
Neither have the ankle injuries gone away; although in the space of a week they were never ever likely to!
But now that Jose Fonté seems to be making some progress its easy to forget that he’s still in that recovery phase where controlled training is preferable to all-in playing and there’s still some way for him to go yet before making a return to full training in the proper sense.
Often all that it takes for people to lose patience is the manager saying that someone’s returned to training and all of a sudden we’re looking for that player to step into the team as if he’d never been injured in the first place.
And then everyone acts totally disappointed when he doesn’t pull on a claret and blue jersey in the following game!
With various other niggling injuries reported, David Moyes’ options remain few and far between for the cup-tie.
While the manager acknowledges that the league is his priority, a decent cup run wouldn’t do any harm to the club either in reputation or financially.
It must be very tempting for him to think seriously about throwing players into the team who aren’t too far off making a return but could easily turn out to be further away from full fitness in reality than anyone thinks.
The final phase of recovery when players are just about ready to return can often turn out to be one of the most difficult stages in the whole treatment and rehabilitation period and that’s when setbacks are most likely to occur.
So although there’s a big cup-tie at Wigan due shortly, it’s going to be a return to work as normal after the game for the West Ham United medical team.
Based on recent events, Sunday is going to be just another day at the office with Gary Lewin and co. hoping that no further injuries are incurred in the Wigan game!