WHEN Duncan Watmore first ruptured his anterior cruciate ligament in December 2016, he had established himself as a first team player with Sunderland in the Premier League and his performances had forced him into the England Under-21 set-up.

Fast forward to April 2018, only two-and-a-half years later, Watmore is recovering from an identical injury, played just six times since, and when he returns to action next season there is every chance he will be performing in League One.

How cruel football, and life, can be? The absence of playing the game he loves has hurt. What has hurt more is the fact he has been powerless to help address the slide down the divisions even if Chris Coleman’s side can keep faint hopes of survival alive by defeating Burton on Saturday.

Watmore has not even figured in a Coleman side because the second cruciate injury inside a year was suffered before he had even taken over. It is worth noting that of the six matches he was involved in before his fresh blow, Sunderland had drawn five and lost just one. Not bad when you consider the amount of times Sunderland have lost this season.

“I was already starting to feel sharp when it happened (in November at Millwall) and I felt that I was able to make a positive impact on the team,” said Watmore.

“What makes it all the more frustrating is the position we are in and the season we have had, and knowing that I haven't been able to help.

“It's my job to play football and I wanted to be able to play my part along with the rest of the lads, but I just haven't been able to and that has been the most frustrating part.”

If Sunderland fail to beat fellow strugglers Burton at the Stadium of Light on Saturday, relegation to League One could be confirmed. It would be the first time since 1987 that the Wearside club has suffered the fall into the third tier.

The prospect of playing at that level wouldn’t concern Watmore after what he has been through, however it is a sign of the size of the club’s problems that League One football is on the cards. He is not making any predictions either.

The 24-year-old said: “You don't want to rush back and do anything silly. I didn't rush back last time, we did everything right and I was just unfortunate – it was a really unlucky tackle, I got caught and it snapped again. It could have happened to anyone. I'm doing the same rehab work again, staying patient, and hopefully I won't have any more bad luck!

“I'm not going to be back for the start of the season, but I'll be back just as soon as I am fully ready. I'm working as hard as I can with the physio Binners [David Binningsley], doing everything possible to make sure that I come back and stay back.

“But even though I might have a target in my head, I don't want to put pressure on myself by saying it out loud. I need to be realistic and understand that, suffering such a serious injury for a second time, I just have to be careful.

“It's going as well it can at this stage. I'm four-and-a-half months into my rehab, and the swelling on the knee is looking good so hopefully I can start running soon.

“I'm seeing the surgeon in a couple of weeks and if he gives the go-ahead, I can start running which will be great. I just have to be really patient with the injury. Second time around, if anything it will take longer, and I can't rush it. Obviously I want to be back and playing but I also need to make sure it's right.”

Watmore was part of the Sunderland set-up, albeit a youth player signed from Altrincham, during his teenage years so was aware of how former Black Cats David Meyler and Fraizer Campbell suffered double cruciate injuries.

Having spent eight months recovering from his first and then having to endure a second so soon after his comeback earlier this season, Watmore is philosophical about the situation.

He said: “I fully expect to return and be back to my best – if not better than before. It will take time, obviously, because I will have been out for so long but I am determined to get back to my best.

“I'm doing everything I can physically, and staying as positive as I can mentally, to do that. I'm just raring to get back playing because I do believe I will come back better than I was before, once I build up my match fitness.

“It was so frustrating for so many reasons – the work I had put in initially, how I was starting to feel – to feel it go again was so frustrating. Then a day or so after the new manager came in, so the timing could hardly have been worse. I had to accept it, I did that quite quickly, and now I am just focused on my rehab so I can get back to playing for Sunderland.”

Regardless of what division Sunderland are in next season, the summer will be a significant one with so much uncertainty hanging around centred on the make-up of the squad and the ownership of the club. Coleman has outlined he would like to stay, but even that is far from certain because of Ellis Short’s ongoing wish to sell up.

Watmore said: “The manager’s been great around the place, he is always positive, and the lads enjoy training. I haven't had any training contact with him yet, but in terms of just being around the place he has been great with me, checking how I am doing and what have you. He just seems like a really good guy.

“I think we've got a really good group here too in the dressing room, with a lot of young lads. That's why it is so hard to explain the season we are having. We're working hard, but for whatever reason it is just not working. I am excited to get back and play with the lads who are here because I know we can put in good performances.”

Duncan Watmore spent time at a disability coaching session at Sandhill View Academy, in Sunderland, as part of a project run by the Foundation of Light and supported by BT Sport.

Along with Lee Camp and Kevin Ball, he helped coach youngsters suffering from hearing impairments and took part in a seven-a-side game.