England used to pre-tournament injury nightmares in past, just not on this scale
David Beckham in 2002 and Wayne Rooney 2006 were both at the peak of their powers going into World Cup tournaments, with England desperate for two talented squads to bring an end to the country's long wait for international football's greatest prize.
But both picked up the same injury, to the same foot bone, meaning every news conference in the tournament build-up was dominated by the fitness of the star player in each side.
This time around, with another talented England group preparing for another shot at ending 56 years of hurt, injuries are again the focus, only this time it is how many key figures, especially in defence, that are in danger of missing out.
It was not so long ago the debate centred around how Southgate was going to choose between the myriad of options available to him, and which high-profile full back was going to miss out on the 26-man squad.
Now, Southgate is going further and further down his list just to fill seats on the plane.
Chelsea's Reece James had stolen ahead of a packed field to make his spot on the right of England's back five his own, but a knee injury picked up on October 11 against AC Milan ruled him out for eight weeks.
Such a break would see him miss England's group opener against Iran on November 21. He remains hopeful of shortening that timescale.
"I will try and not rule myself out," he told The Sun newspaper. "The Chelsea medical staff have not given me a percentage of my chance of being back for the World Cup. It's down to how I feel closer to the time and how stable it is."
The form of Newcastle United's Kieran Trippier has softened the blow, meaning he could step into the fold, but Trent Alexander-Arnold's patchy start to the club season for Liverpool has left little room for manoeuvre in that position for the England boss.
Manchester City's Kyle Walker, who has fulfilled both the right-sided centre back role and wing-back position for his country, would almost certainly be a starter against Iran, but he is also injured, having not played since early October.
On the other flank, another Chelsea full back, Ben Chilwell, limped off in the Champions League against Dinamo Zagreb on Wednesday. He also faces a race against time to be fit.
Things are no rosier centrally. Of the three centre backs who started against Italy in last year's Euro 2020 final, Walker is injured, John Stones has only just returned to first-team action at City and has started six league games all term, while Harry Maguire has barely featured for Manchester United.
Maguire has been a regular throughout Southgate's tenure, but has been demoted at United, starting only three league games this season. Whether they are out-of-practice or confined to the treatment room, Southgate's backline is looking fragile.
Rooney later suggested that going to the 2002 World Cup injured and playing through the pain was a mistake. Southgate's dilemma is does he risk defenders who have served him so well but aren't at 100%, or give others a chance.