IF Steve McClaren grimaced as much as Wayne Rooney when he learned of the striker's latest fracture then you could hardly blame him.
England without Rooney are like fish and chips without salt and vinegar. Solid enough. Wholesome in parts, but lacking the essential ingredients to be described as truly tasty.
It is why Rooney's injury, which rules him out for two months, is so debilitating to McClaren's chances of qualifying for the European Championships.
Even with Rooney England have done little under McClaren to suggest they possess enough organisation and class to progress from what was supposed to be one of the easier qualifying groups.
Dropped points against Macedonia, Croatia and Israel have piled the pressure on Wembley matches next month against Israel and Russia, leaving the match against Russia in Moscow on October 17 as perhaps the trickiest of defining contests.
At best England have been mediocre, at worst shambolic these past 12 months.
But there was always the hope that Rooney would start the new season with the dash and goalscoring verve to ignite England's challenge.
Without him it is difficult to see from where the guile or the goals might come.
Of course Steven Gerrard is capable of rousing the troops. His surging presence is crucial in England's midfield, where Owen Hargreaves should provide a protective shield to a defence which might yet be without John Terry if the Chelsea captain's damaged knee ligaments do not heal in time.
But it is goals in the most crucial matches which England have lacked under McClaren.
England have lots of solid professionals but they do not possess men of inspiration.
Not with Michael Owen's fitness in doubt, Dean Ashton returning tentatively after a year out and Peter Crouch struggling to make the Liverpool line-up - while being suspended in any event for the visit of Israel.
When you consider that McClaren's other options are Darren Bent, Tottenham's big money reserve, plus Jermain Defoe and Everton's Andrew Johnson the paucity of world class striking talent becomes apparent.
Even Alex Ferguson, not a man to waste too much sympathy for his international counterparts, admitted: "It's a blow for England."
It also highlights the over-reliance of England's big tournament hopes on the man who Sven-Goran Eriksson somewhat prematurely likened to Pele at the European Championships in 2004. Once Rooney limped out of that tournament with a metatarsal fracture, sustained in the quarter-finals against Portugal, England's momentum and hopes had gone.
When another foot injury again deprived Rooney of full fitness England's World Cup campaign in Germany was also undermined.
Losing Rooney is like England's rugby team being deprived of Jonny Wilkinson or the cricket side missing Kevin Pietersen at his belligerent best.
Against defensively-organised and physical opponents such as Russia victory often rests on one surging burst of brilliance or a moment of magic. In short, the tools of Rooney's trade.
The sadness for McClaren is that England have no-one to fill his creative boots. United do, in Carlos Tevez.
The Rooney incident occurred near the end of the first half of Sunday's 0-0 draw at Old Trafford when Rooney fired a low cross from Michael Carrick just over the crossbar.
In attempting to make a tackle, Michael Duberry accidentally trod on Rooney's foot. It was clear instantly Rooney had a problem, as he went down and removed his boot.
Although he was able to continue briefly, he did not reappear for the second half, with Ferguson sending the 21-year-old for a scan which confirmed United's worst fears.
Although the United boss expressed the hope the damage would not be too bad, his worst fears were confirmed.
Certainly, Rooney will miss United's forthcoming Premier League encounters with Portsmouth, Manchester City and Tottenham this month and matches against Sunderland, Everton, Chelsea and Birmingham in September.
Meanwhile, Nike last night insisted the design of their boots had "nothing to do with" Rooney's latest foot injury.
Charlie Brooks, head of communications for Nike UK, said the boot (the Total 90 Laser) that Rooney had been testing was not to blame.
He said: "He (Rooney) himself is personally absolutely confident, as we are, that the boot had nothing to do with his injury. Nearly 20% of the professional players in the Premier league this weekend were wearing this boot.
"I think it is a boot that stands up to all kinds of testing, and stands up to on-pitch demand.
"I think what happened to Wayne is an unfortunate football injury."