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Manchester United manager Erik ten Hag says his club's ongoing injury issues are holding them back.
Last season United suffered 45 injuries - more than any Premier League rival - while they were without 10 first-team players for Thursday's Europa League draw with Fenerbahce - nine because of injury.
And while veteran central defender Jonny Evans could return for Sunday's trip to West Ham, there are huge doubts over Brazilian winger Antony, who went down with no-one near him after coming on as a second-half substitute in Turkey and had to be carried off on a stretcher.
Defensive trio Luke Shaw, Leny Yoro and Tyrell Malacia are all yet to make an appearance this season, while Mason Mount has made five, including the Community Shield, and is currently in his second spell out of action in this campaign alone.
"Yes, it holds us back in our levels and also in our position in the league," said Ten Hag. "When you don’t have the players available, you can't line up the best team."
United hoped they would solve their problems through the hiring of Gary O'Driscoll from Arsenal as their new head of medical 12 months ago.
But it hasn't happened and Ten Hag knows his side will struggle to fulfil their potential until an answer can be found.
"We need more players available often," he said. "We all have to work together on this point - the players, the coaching staff and all the other staff.
"We have to do better at that because we know when we have them we are a really tough team to play and we can be really successful."
United go to London Stadium 12th in the Premier League, and now 21st in the expanded Europa League, after a run of three away draws and a home win over Brentford in the four games since the shambolic home defeat by Tottenham on 29 September that led to intense speculation over Ten Hag's future.
Because they lost that game, United's draw with Fenerbahce means they have won once in seven games in all competitions.
Had they been victorious, it would have been an unbeaten run of nine, their longest since the early months of 2023.
The recent sequence of away draws are all creditable given they represent their hardest two Europa League games and a trip to high-flying Aston Villa, when they had a day less to prepare.
Now they face a West Ham side smarting from their London derby defeat at Tottenham, who have had a whole week for manager Julen Lopetegui to sort out their problems.
Ten Hag looks back on that loss to Tottenham, when his side were totally outplayed but only a goal down when Bruno Fernandes was sent off late in the first half - only for the decision to be ruled incorrect and the suspension overturned later by a disciplinary panel - and claimed the circumstances mean it is unfair to judge his players.
"I deny that game," he said. "I ignore that game against Spurs because we were downsized to 10 and the red card was overturned.
"It is not a fair assessment of the team to take this into consideration because we didn’t have the chance to bounce back. Of course, it was a tough first half, but in that period is also remember some very good chances.
"But you see this team is resilient and determined. Against Brentford and in tough away games, this team has showed character, fighting spirit and determination to win games."