Jonny Wilkinson's right ankle, just about the only part of the World Cup-winning outside-half to have functioned properly since England's night of nights in Sydney four years ago, finally gave way yesterday – a deeply unwelcome development that sent the champions into a tailspin 96 hours ahead of their meeting with the United States in Lens.
Wilkinson was instantly withdrawn from the line-up and whizzed off to the local hospital for a scan. Brian Ashton, the head coach, could not say whether he would recover in time to face South Africa in nine days' time. What he did know was that this was a case of déjà vu, all over again.
The 28-year-old Newcastle player fell awkwardly during a brief "non-contact defence session" supervised by one of Ashton's assistant coaches, Mike Ford. If the England camp were of a mind to look on the bright side, they might feel grateful for the fact that it was not a "full-contact defence session". There was nothing bright about their mood, though. "If this injury rules him out of the Springbok game, it will certainly be a blow to us," acknowledged Lawrence Dallaglio, the former captain who will start at No 8 on Saturday.
Wilkinson turned his ankle jumping out of the way of Steve Borthwick, the 18st lock from Bath. As a result, another Bath player, Olly Barkley, will wear the No 10 shirt against the Americans. "I've paid Steve off already," said Barkley in a half-hearted attempt at humour. "Actually, it's far from ideal for us. I want to play well enough this weekend to give the coaches a selection headache, but at the same time, Jonny has been fantastic with me over the last couple of weeks and I'm really sorry this has happened. I have no idea about the extent of the injury, but he was in a fair bit of pain."
No rugby player on earth is more familiar with pain than Wilkinson, whose career since dropping the goal that won the 2003 tournament has amounted to little more than a lengthy treatise on orthopaedic medicine. He underwent a risky form of surgery to repair ravaged nerves in his neck – a long-standing condition that threatened to force him into retirement at 24 – before being hampered by a series of less alarming problems: a blood-clot on his biceps; mangled knee ligaments, persistent groin trouble, an outbreak of appendicitis. Then, he suffered a lacerated kidney during a Premiership match on Tyneside, which signalled a return to full-scale trauma.
Recalled to England colours at the start of this year's Six Nations Championship, he negotiated two games before delivering a below-par performance against the Irish in Dublin – there were strong rumours that he had ignored medical advice and played injured – and sitting out the remainder of the tournament. Now, he finds himself sitting out the first 80 minutes of the biggest tournament of all. "He's philosophical, as ever," reported Ashton. Philosophical? Socrates himself would have been tempted to kick the cat.
Try as he might, the coach cannot find a way of fielding his strongest side. England's summer tour of South Africa was a bad joke – 30-odd players unavailable, two 50-point thrashings – while last month's warm-up matches were adversely affected by injuries to Mark Cueto, Tom Rees and Lewis Moody. But despite the Wilkinson issue, yesterday's team announcement shed considerable light on Ashton's thinking in some of the most difficult areas of selection.
He is clearly committed to running Cueto at full-back, despite the Sale player's pratfalls against France in Marseilles two and a half weeks ago, while Dallaglio has seen off the challenge of Nick Easter. Ben Kay, a member of the triumphant 2003 side, will play in the middle of the line-out ahead of Borthwick, who had a rough time of it in France last month, while Joe Worsley returns at blind-side flanker, joining two fellow Wasps in the back row.
Not for the first time, it was the midfield combination that caused the most grief. Ashton has asked his friend and confidant Mike Catt, one of the oldest players in the tournament at 35, to fill the exasperatingly problematic position of inside centre – a position once earmarked, at huge cost to the Rugby Football Union, for the former Great Britain rugby league captain, Andy Farrell. In the initial selection, Barkley was named on the bench. Farrell would have been among the eight players considered surplus to requirements, but for Wilkinson's misfortune.
As it is, Farrell will be the second goal-kicker – an obvious concern, given that he has no experience of marksmanship under union rules, where penalty shots from 40 metres-plus are the norm, not the exception. For this reason alone, Ashton would have preferred Wilkinson to be present and correct. "We wanted him to play in this game – it's why we picked him," the coach said. "But we'll have to get on with it. If I spent my life worrying about what was happening to this or that player, I'd have even less hair on my head."
Up the road in Lille, where the Americans were to be found preparing for the game, there was a degree of optimism, if not any serious expectation of upsetting the applecart. "I think people may be quite surprised at the size of some of our players," said their coach, Peter Thorburn. "We have a very big forward pack and we hope to be competitive."
His words were echoed by Marty Wiggins, an Australian charged with bringing the USA scrum up to scratch. "We have to be realistic: England are good. But we will not be daunted or overwhelmed."
Wilkinson's woes: World Cup-winner's catalogue of injuries
May: Suffers ankle ligament damage in Newcastle's defeat by Gloucester, ruling him out for the rest of the season.
December 13: Newcastle confirm Wilkinson has fractured part of his shoulder. Falcons predict an absence of two to three weeks.
December 28: Suffers a recurrence of his shoulder injury and has to come off during Newcastle's win over Northampton.
February: Ruled out of Six Nations after shoulder op.
October: Ruled out for up to six weeks with a haematoma in the upper right arm and has to stand down as England captain for autumn Tests.
January: Suffers knee ligament damage in Newcastle's Heineken Cup defeat in Perpignan.
March: Suffers medial ligament damage on Newcastle comeback against Harlequins.
July: Suffers a shoulder injury during the British and Irish Lions' second Test defeat in New Zealand. Misses third tie in the series.
September: Ruled out of early season action after undergoing an appendix operation.
November: Has a major operation for related groin problems.
January: Suffers a torn adductor muscle.
September: Forced off with a knee ligament injury suffered during Newcastle's home game against Worcester, effectively ending his hopes of playing in the autumn Tests.
November: Makes comeback for Newcastle against Bristol but suffers kidney damage and requires one month's rest.
September: Suffers fresh injury blow as a twisted ankle in training rules him out of England's opening World Cup pool game against the US.