Kengo Nakamura suffered a broken jaw in Kawasaki Frontale's ACL loss to Seongnam Ilhwa on Tuesday, leaving Japan boss Takeshi Okada with a question mark hanging over another one of his squad members as the countdown to the World Cup finals continues.
Despite being knocked out and no doubt in some serious discomfort, Nakamura played on after regaining consciousness before being checked over by a doctor in Yokohama, who confirmed the broken jaw and arranged for immediate surgery.
Nakamura is now expected to be out for several weeks, meaning both he and Yoshito Okubo - two of Okada's likely starting line-up - are now sidelined as the team prepares for the finals. Japan face Bahrain in an Asian Cup qualifier on March 3 but, with both teams having qualified, neither is likely to be overly concerned about the result.
The Bahrain game, however, is now the perfect opportunity for Okada to overhaul his starting line-up. Nakamura, despite being among the nominees for the Asian Player of the Year Award, is simply not good enough to play against the best players in the world - he's fine at J.League and Asian level, but he's not strong enough physically or psychologically to handle the tests that await at the World Cup. Much like the rest of the Japanese midfield, he's also a little ponderous in possession.
The hope has to be that Okada will now look to try out some different combinations against Bahrain. Junichi Inamoto proved he's back to somewhere approaching his best form at the East Asian Championship (one of the few plus points for Japan at that tournament) while Shunsuke Nakamura is returning to Japan for the game, whether he has signed for Yokohama F Marinos by then or not.
A midfield featuring Inamoto, Shunsuke Nakamura, Keisuke Honda and Makoto Hasebe might actually have the strength and guile to do more to opposing defences than what the Japanese have been doing recently. That, of course, would mean Asian Player of the Year Yasuhito Endo also sitting on the bench, but Endo - much like Kengo - doesn't tend to cut it against the world's best. Honda, by contrast, can pass but also has a steely determination and is prepared to put his foot in where other Japanese players might back out.
In attack, Okada has tended to stick with Okubo even though the striker has failed to come close to realising the potential he had as a youngster. He's become arrogant but has not turned into the game changing player he promised to be in his youth. Alongside Keiji Tamada, he presents little threat at all.
Instead, perhaps, Okada should be looking to use Takayuki Morimoto - a player with a direct style and the skills required to utilize it to something approaching the fullest effect - while alongside him Naohiro Takahara could make a return. Takahara has barely featured for the national team in recent years and has also been in and out of form at Urawa Reds, but he can hold the ball up better than many other strikers in Japan (something the technically inept Sota Hirayama still struggles to do) and has a decent physical presence that he's not scared to use. He would also give Japan a bit more leadership up front, which is something that has been lacking throughout the whole team lately.