England face the problems before the Adelaide Test

Whatever the personnel when the sides are announced prior to the start of the second Ashes Test in Adelaide, Australia will start the match as firm favourites to go two-nil up in the series. England's plans have been thrown into disarray by a succession of injuries, while Australia could put their second eleven on to the field and still be favourites to win. Australia A could not force a win in Hobart in the tourists' last match, but they certainly did nothing to restore England's confidence.

Before dwelling on England's misfortunes, it should be said that Australia themselves are not completely free of injury doubts. Jason Gillespie is still feeling the effects of his calf strain and is being given as long as possible to recover. If he cannot do so, Brett Lee will come back into the side.

Lee has taken 21 wickets for New South Wales since being dropped from the side for the first Test in Brisbane and has recaptured the speed that made him such a fearsome proposition until his recent dip in form. If Gillespie is fit, Lee might have to wait until Perth before regaining his place as he has said himself that his replacement, Andy Bichel, has done a perfectly good job for the side.

England would dearly love to have a problem like that of the Australians. At the start of the tour, captain Nasser Hussain said that his side stood a chance of regaining the Ashes provided fortune smiled and he could call on a full complement of fit players. The decimation of the party and their dream began before they left England. That was when Graham Thorpe dropped out of the original selection to be replaced by Robert Key.

A damaging blow, but at least Key was fit and raring to go. The same could not be said for the rest of the party. Darren Gough (knee), Michael Vaughan (knee), Mark Butcher (knee), Andrew Flintoff (hernia), and Simon Jones (rib) were all travelling with injuries of varying degrees of seriousness to overcome.

Vaughan and Butcher came through without further mishap. Gough never took the field before returning home to seek further career-saving medical help. Flintoff has simply failed to get over his hernia operation as expected and is now said to be out until the fourth Test. There was no problem about Jones' rib, but then he suffered that horrendous knee injury on day one at Brisbane and is out for the rest of the tour and into the foreseeable future.

Add to that casualty list the shoulder scare concerning Marcus Trescothick, the shin splints suffered by Steve Harmison, and a bout of concussion, the bruised hip that makes John Crawley doubtful for Adelaide, and the fractured wrist sustained by Ashley Giles, and it is no wonder that the England dressing room resembles a casualty clearing station. Of the 16 names announced by the selectors on 10th September, only six have not featured in medical bulletins.

Hussain has criticised some of the medical advice that was furnished before the tour started, but coach Duncan Fletcher has been philosophical about it.

"Medical advice isn't a perfect science so it's difficult," he admitted. "Some of the advice we've been given has been pretty close but everybody's got to get involved in this and the players have to make sure they carry out the procedures given to them.

"In any team you have certain people who look after their own fitness problems and there are other people who need just a little bit more guidance.

"Vaughan was spot on and we realised that Gough was a risk and Flintoff would be ready about a week before the Test, but it's not a perfect science and suddenly he was probably about a week too late."

Talking about the situation at the end of the first Test, Fletcher pointed to the appointment of a specialised medical officer for English cricket as being a step in the right direction.

"Once he is appointed that will centralise everything which is very important. At the moment I believe our physiotherapists are being treated like doctors and they're not medical people at all.

"It will be a huge advantage once that Academy is set up at Loughborough because we'll be able to send guys along there while we're away on tour and we'll have one central place where people can take control of the situation."

However, writing in the Sunday Telegraph, former England captain Michael Atherton was rather more scathing about the current medical back-up.

"For some time I have felt that the medical side of England's cricket is more amateurish than it might be, lagging behind the increasingly professional set-up as a whole," Atherton wrote. "Flintoff's case clearly illustrates the point."

Atherton then pointed out that Flintoff should not only have missed the Headingley Test against India to have the operation as soon as possible, but that he was not given proper rehabilitation advice.

"After the Headingley Test, Ian MacLennan, a highly regarded groin and hernia specialist in Manchester, operated on Flintoff. For the first few days after that he was given some gentle rehabilitation exercises, but there was little communication between the England and Wales Cricket Board and the player, who, after the initial exercises, had no idea of the more strict, day-to-day rehabilitation he should have been undertaking. In the following fortnight Flintoff saw the ECB medical staff only once, during the last Test at The Oval, to have his stitches removed."

Atherton continues: "At the end of the season, with England off to the Champions' Trophy in Sri Lanka, Dean Conway, the England physiotherapist, rang Lancashire to ask them to take charge of Flintoff's rehabilitation. Lancashire were playing at Canterbury and Taunton and Flintoff remained in Manchester, when his rehabilitation finally got under way. After six days Flintoff was taken out of Lancashire's care and instructed to go to Lilleshall for two-and-a-half weeks. Initially he was told that he was not to be booked in and he would be expected to drive there and back each day, although eventually common sense prevailed and a room was found. From this point until arriving in Perth, Flintoff did not see anybody from the ECB."

It is not suggested for a minute that any individual is to blame for this sorry state of affairs. All concerned have strained every sinew of their being to do a good job for England, but somewhere along the way the system has failed and needs attention. Perhaps the appointment of the medical officer will achieve that, as Fletcher has suggested.

That is all history. What matters now is that England manage to restore some pride and make the most of what they have available. Whatever the result, a battling performance in which team and individuals do themselves justice would go a long way towards bolstering credibility. And a little bit of luck would not go amiss.

As for the Australians, they must be really worried. Consider the dilemma that is occupying them even once they get the Gillespie situation sorted out. How do they resolve the problem of getting Martin Love - the man who averages 451 in two innings against the tourists - into the Test side. No wonder their selectors have furrowed brows.