Steve Borthwick has been handed a mounting injury headache ahead of the Nations Championship, with eight England stars currently sidelined.
The latest round of PREM team news has added to England's concerns, with several established internationals unavailable for their clubs.
Some are expected back before the Nations Championship begins, but others have already been ruled out.
Here are the eight players currently on the sidelines.
1. Sam Underhill
Underhill is one of the biggest blows.
The Bath flanker suffered a bicep injury and has undergone surgery, ruling him out for several months.
That means the 30-year-old will miss the Nations Championship.
2. Bevan Rodd
England's loosehead options have also taken a hit.
Rodd suffered a scaphoid injury and required surgery, with Sale expecting him to be sidelined for between eight and 12 weeks.
That timeframe rules him out of England's November campaign.
3. Ellis Genge
Another loosehead Borthwick will be monitoring closely.
Genge suffered a wrist injury and has subsequently been stood down by Bristol.
The good news is that his absence is not expected to be lengthy, with the England star potentially returning within a few weeks.
4. Marcus Smith
Smith is currently unavailable for Harlequins after suffering a broken finger.
The England playmaker has avoided a lengthy absence and Quins are hopeful of having him back soon.
Nevertheless, it is another unwanted fitness concern just weeks before Borthwick brings his squad together.
5. Fin Baxter
Baxter has been working his way back from the foot injury which has kept him sidelined.
The Harlequins prop is closing in on a return, but his lack of rugby before the international window could become a consideration for England.
With Rodd definitely out and Genge currently injured, his recovery has become even more important.
6. Alex Dombrandt
Dombrandt is another long-term absentee.
The Harlequins number eight suffered a serious knee injury and is expected to miss a significant chunk of the season.
England still have considerable depth in the back row, but his absence removes another experienced option.
7. Ben Curry
Curry has been unavailable for Sale with a hamstring problem.
The flanker is understood to be getting closer to returning, but he misses this weekend's PREM action.
Borthwick will hope Curry can quickly get some rugby under his belt before England's campaign begins.
8. Tom Roebuck
Roebuck completes the current list after being sidelined by a calf injury.
Like Curry, the Sale wing is moving closer to a return.
The 25-year-old has become a regular member of the England set-up and was involved throughout 2025, making his fitness particularly important as Borthwick finalises his back-three options.
Borthwick's mounting headache
Not every player on the list is expected to miss the Nations Championship.
However, Underhill and Rodd are already out, while the coming weeks will determine whether several others can prove their fitness and build enough match sharpness.
England's front row looks particularly vulnerable.
Rodd is unavailable, Genge is currently sidelined and Baxter is only now approaching his comeback.
Borthwick will therefore be watching the next few rounds of PREM action very closely before naming his squad.
