Poor David Moyes.
Injuries have been crippling with Vito Mannone, Seb Larsson, Fabio Borini, Lee Cattermole, Jan Kirchhoff, Paddy McNair, Duncan Watmore and Billy Jones all having spent, or are spending, lengthy spells on the sidelines.
The midfielder’s dodgy calf looks the biggest obstacle to his participation.
Some absences have been through suspension with Steven Pienaar, Papy Djilobodji and Didier Ndong sitting out games in the recent good run due to one game-bans. At no point has the Black Cats boss been able to say “same again”.
This week’s enforced change at Old Trafford he knew was coming – the deal which brought Adnan Januzaj on a season-long loan to Sunderland forbids him from facing employers Manchester United.
The gifted 21-year-old has shown glimpses in the last two games of the sort of ability he possesses.
But they won’t be seen at the Theatre of Dreams, so where will Moyes turn to replace him?
Here are the options.
The talented attacker has found himself in chilly climes ever since the 4-1 home defeat to Arsenal.
Not totally out in the cold, it has to be said, but Khazri has been a sub for the last seven matches, which have brought the Black Cats four wins.
He has spent longer warming up down the touchline than he has inside the lines, coming on late on against Chelsea and extremely late in the win over Watford.
The most gifted of the four candidates, the one most likely to deliver a killer ball, he is probably the least likely to actually replace Januzaj.
Typing in the name of the midfielder immediately brings to mind his part in one of Sunderland’s greatest triumphs in recent years.
The Swede bagged the first-half goal which gave Sunderland their first win at Old Trafford since 1968 and took them to within touching distance of safety under Gus Poyet.
Larsson would not be a bad choice for the Black Cats, his experience is vast in relegation fights, playing in front of a 75,000 crowd is not going to faze him and he has a trusty right boot which could come in useful at set-pieces.
The 31-year-old helped Sunderland to victory over Hull when he came on as a sub and also left the bench against Chelsea.
His one start since his comeback, at Swansea, was decent enough, just failing to get on the end of a Patrick van Aanholt cross when the side was trailing 1-0.
While Larsson will fondly recall his trip to Old Trafford from 2014, this man has a lifetime of memories from United.
The defender spent over a decade there, winning medals galore, and will be guaranteed a warm reception.
But he is likely to be needed to silence the home fans on Boxing Day.
O’Shea is the player who is favourite to take over from Januzaj.
Moyes used O’Shea in the middle of a three-man defensive unit seven days ago against Chelsea and it worked very well.
While the Blues dominated possession, it wasn’t as if the home goal was being peppered, so the 35-year-old Ireland centre-half is a likely figure for Moyes to turn to on Monday.
The third 30-something of our list of candidates, the midfielder’s dodgy calf looks the biggest obstacle to his participation.
This fella is not short of experience and expertise and would be an ideal replacement, if fit.
Pienaar was out of work when Moyes picked him up in the summer, the South African having been released at the end of last season by Everton, where Moyes had previously worked with him.
He wasted glorious chances at both Tottenham and Liverpool, but his general presence in midfield has been crucial, notably in the 2-1 win over Leicester, a match in which he helped set the attacking tone before being injured. With big games coming up, Moyes may not want to risk him even if ‘fit’.