Sunderland v Leeds United: Injury news Whites feared complicates familiar EFL juggling act for Daniel Farke

The Whites go into potentially one of their toughest games of the season at the end of one its toughest schedules on the back of the news that Ilia Gruev has become the second player sent for knee surgery in a matter of days.

The Bulgarian midfielder injured his right mensicus in Tuesday’s 1-1 draw at Norwich City and his club’s worst fears have been realised with the news he requires surgery.

Leeds decided late last week that Max Wober would also have to go under the knife, then on Saturday Ethan Ampadu was ruled out for the rest of 2024 with a knee problem of his own.

It means the problems all Football League sides are wrestling with this week are that much worse for the Elland Road club.

Championship, League One and League Two sides played league games last Saturday, another in midweek and a third this weekend. Leeds’ final game comes a day earlier than the rest, and against the Championship leaders to boot.

On top of that, it is the second of two away games this week.

The latest spate of injuries mean that at centre-back, central midfield and out wide the drop in quality should Leeds make changes will be greater than usual.

Few rivals will have much sympathy for a club with the Whites' formidable resources but it does make for some difficult decisions ahead of the game at the Stadium of Light.

“It's always a tricky period but to be honest I'm used to it,” said manager Farke, now in his fifth season as a Championship manager. “This is even by Championship standards a bit special with three games in six days and two away games as the second and third game and you have to adapt.

“If you don't use your options in your squad and try to share the minutes a little bit when you have three games within six days there's never a time to do this.

“If you always play with just 11 players it would send a completely wrong sign to the players in our squad. It's important they all have the feeling they're needed.

“When you have more injuries you monitor the players even more.

“For example the wingers, with Daniel James and Manor Solomon – two really important players for us – not available you want to make sure players like Willy Gnonto and (Largie) Ramazani are ready to start three games within six days. Normally you would mix it up a bit.

“To make sure they can start all three games and deliver you speak a lot with the medical department about how we can support their recovery, their nutrition, their good habits, their sleep. It's important.

“We get advice when their workload drops down during a game and they seem to get tired. We can't afford another injury.”

One of the more difficult decisions could be over Ramazani, who will certainly play if the team is picked solely on form, but there are other factors to consider with a 23-year-old playing English senior football for the first time.

“He came from a side (Almeira) with a different football culture in a different country,” said Farke. “It's never easy when you're relegated to the second tier (in Spain) and he wasn't involved in every game due to some bookings (and red cards) and some injuries.

“He didn't have the easiest pre-season and arrived (at Leeds) pretty late once the season was already started.

“In the beginning of course we were convinced of his potential but his physicality needs some improvement. We've worked hard with him and he's improving day to day.

“I'm pretty pleased he's already had a deep impact with end product – two goals and one assist.

“This was always the question mark, even in La Liga. Also his defensive workload – when he works back he can be pretty stable and good in terms of defending but there's still some improvement to make.

“The first goal against Norwich, we could have avoided the winger cutting inside. There's still something to improve and also the workrate. He can cover more distance. But I'm pretty pleased right now he's already capable if he makes it into the starting line-up to play three games in six days in this league.”