WHEN Steven Fletcher was stretchered off five minutes into Scotland’s World Cup qualifier against Wales last Friday, hearts sank on Wearside.

The thought of being without their leading scorer for a number of weeks only heightened the concern of supporters who already knew their team is embroiled in a relegation battle.

Hopes may have risen slightly with the suggestion Fletcher could return before the end of the season, but they vanished yesterday when Martin O’Neill confirmed the worst: his record signing wouldn’t feature again this campaign after suffering ankle ligament damage.

And as if things couldn’t get any worse, captain Lee Cattermole was also ruled out for the rest of the campaign after he underwent a knee operation yesterday.

It is a huge double blow for the Black Cats, who sit four points above the bottom three with games against Manchester United, Chelsea, Newcastle and Everton ahead of them.

The update on Cattermole hardly came as a surprise given the fact he hasn’t featured since the beginning of February, but being without their 11-goal striker sets the alarm bells ringing.

“One way or another he misses the rest of the season, which is a blow and that’s following on from Lee Cattermole, who has also had an operation,” the Black Cats boss revealed.

“Steven will miss the rest of the season, he has ankle ligament problems. His ankle will have to be put in a non-weight bearing plaster for a fortnight and then when that comes off we’ll see if he needs an operation, but either way it rules him out of the remaining games.

“We’ve had to do without Lee for most of the season, so that news isn’t unexpected, but it’s a blow for Fletcher.

“I was watching the game and saw him go down. When a stretcher comes on you always fear the worst, but we have to get on with it.

“That’s the risk you run when you have players away on international duty.

Anything can happen. We have to get on with it, it’s a big blow and one we could have done without at this stage of the season.”

O’Neill faces the media this morning to preview Manchester United’s visit to the Stadium of Light, fully aware the pressure is on to find an alternative to Fletcher’s goals.

Expectations will fall at the feet of January signing Danny Graham, but he is yet to get his Sunderland account up and running and O’Neill must find an effective formula to help him get a breakthough as soon as possible.

He might have lost two of his most valuable assets, but when you look at the attacking players at his disposal, there are plenty of options O’Neill could adopt.

If he is going to extract the best from £5.5m man Graham, looking at a 4-3-3 formation could be worthwhile.

The Gateshead-born forward is more than familiar with this system and he thrived playing in the role alongside Scott Sinclair and Nathan Dyer at Swansea.

Of course, those players were at the height of form when they guided the Swans to an 11th-placed finish last season and Sunderland would need a combination of Adam Johnson, James McClean or Stephanie Sessegnon to up the ante considerably.

McClean offered O’Neill a reminder of what he is capable of in his outings for the Republic of Ireland this week, while Sessegnon has looked more dangerous in recent weeks.

The attacking trio has come in for some criticism for their below-par performances this season and if there was ever a time to turn it around, it is now.

There is a justifiable argument that Sunderland would be better off tightening things up for United’s visit at the weekend and that could see the Sunderland boss switch back to the 4-5-1 formation he used often in the previous campaign, although that option would hardly warmup the Stadium of Light crowd.

Supporters called for Fletcher and Graham to be paired together weeks before the boss eventually played them both and there is scope for Graham to be supported by someone like Sessegnon playing just off him – or even Connor Wickham.

O’Neill has been reluctant to play the 19-year-old, but some much-needed game time during a month-long loan spell at Sheffield Wednesday and some impressive performance for the England Under-21s will have given the former Ipswich Town striker a lift in confidence.

Whatever O’Neill decides to do on Saturday, he needs it to work – but above all it is grit and determination Sunderland need.

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