The World Cup does not begin for a week but the buildup claimed some high-profile victims Friday, including England captain Rio Ferdinand and prolific Ivory Coast striker Didier Drogba.
Ferdinand was ruled out of the World Cup on Friday after injuring his knee in the team's first full training session in South Africa.
A continent away in Switzerland, Drogba told a teammate he was out of the World Cup after breaking his right elbow in a 2-0 friendly victory over Japan.
Italy playmaker Andrea Pirlo is resting at home in Milan with a calf injury that could force him out of some of the world soccer championship. Brazil goalkeeper Julio Cesar missed practice for the second straight day as he recovers from a back injury.
Brazil goalkeeper Julio Cesar missed practice for the second straight day as he recovers from a back injury.
And American striker Jozy Altidore has a sprained right ankle that makes him doubtful for Saturday's warmup match against Australia.
Injuries have run through nearly every team from every continent well before the World Cup begins. Nowhere is the agony stronger than in Ivory Coast.
Ferdinand, a 31-year-old centre back sustained the ligament damage to his left knee while defending against striker Emile Heskey at England's training ground near Rustenburg a week before England's opener against the United States in this northern South African city on June 12.
Out 4-6 weeks
Scans showed that Ferdinand will be out for four to six weeks and his place in the squad will be taken by Tottenham defender Michael Dawson, while midfielder Steven Gerrard assumes the captaincy.
"It is obviously bad news and everyone with the squad is very disappointed and sorry for Rio," England coach Fabio Capello said. "It was an accidental injury in training, but had nothing to do with the pitch."
It came at the end of another injury-restricted season for Ferdinand at Manchester United. Plagued by a long-standing back problem, the defender was restricted to just 12 starts for United.
Matthew Upson or Ledley King, who has chronic knee problems, are likely to take Ferdinand's starting spot in central defence alongside John Terry.
Dawson was cut from the preliminary 30-man squad on Tuesday but put on standby as a possible replacement for Ferdinand. Under FIFA rules, injured players can be replaced up to the day before the opening game.
Another concern for Capello is the fitness of injury-prone goalkeeper David James, who was unable to train with his teammates at the Royal Bafokeng Sports Campus and had to work separately in the gym.
James is competing for the starting spot with Robert Green and Joe Hart.
But there was more positive news regarding Gareth Barry, with the midfielder training for the first time since injuring his right ankle a month ago.
Barry makes cut
The ligament damage sustained by Barry playing for Manchester City on May 5 made him a doubt for inclusion in the 23-man World Cup squad, but he made the cut after a medical check on Tuesday.
Former captain David Beckham, whose World Cup campaign was ended by an Achilles' tendon injury, has been allowed to travel with the squad to help the players.
Drogba, one of the world's best strikers, led Chelsea to the English Premier League title this season, scoring 29 goals. But he told teammate Kolo Toure that he will miss the World Cup after being hurt in the warmup match in Sion, Switzerland.
"For him, he said, the World Cup is finished," Toure said.
The 32-year-old Drogba was taken off 15 minutes into the game after a high challenge by Japan defender Marcus Tulio Tanaka. He was then rushed to a hospital.
"We can just see on his face that he was sad, and when he is like that you can't ask more," Toure said. "It is difficult for us because he is such a really important player."
Pirlo, the player of the match when Italy beat France to win the 2006 World Cup, injured his left calf in a friendly loss to Mexico on Wednesday and will sit out the warmup game against Switzerland on Saturday.
The Italian Football Federation said the midfielder will travel with the team to South Africa and continue to be evaluated ahead of Italy's first match, against Paraguay on June 14. A team doctor said such injuries take 15 to 20 days to heal.
Julio Cesar underwent physiotherapy at the team's hotel Friday. He fell awkwardly and injured his back in the team's 3-0 win over Zimbabwe on Wednesday in Harare. Doctors say the injury is not serious and should not keep the goalkeeper from playing in Brazil's opener against North Korea on June 15.