How will Ballard injury impact Northern Ireland?

In a huge blow to Northern Ireland's hopes of reaching a first World Cup since 1986, Sunderland defender Dan Ballard has been ruled out of the play-off semi-final in Italy.

A hamstring injury for the Sunderland defender means that Michael O'Neill will be without two of his four Premier League players for the crucial game.

Conor Bradley is also absent with a knee injury, which leaves Trai Hume and Justin Devenny as the only players who have played in the top flight this season.

But how will Northern Ireland cope without Ballard, and who could replace him?

In the past year, Ballard has been unavailable for Northern Ireland as much as he has been able to play.

A hamstring injury ruled him out of March's friendlies with Switzerland and Sweden last year, and he also missed the opening two qualifiers in Luxembourg and Germany with a knee issue.

The 26-year-old also sat out the final qualifier at home to Luxembourg, which was a dead rubber, through suspension.

Of the five games he has missed, Northern Ireland have lost two, won two - both against Luxembourg - and drawn once.

A physical presence, Northern Ireland have conceded four goals in the five matches that Ballard has played in, compared to 10 when he has been unavailable.

Five of those came against Sweden, when O'Neill was not only without Ballard but also Trai Hume and Bradley in a weakened NI team.

At the other end of the pitch, Ballard is also a threat and has scored five goals in his 33 caps.

He did not find the back of the net in his three qualifying matches last year, but did have an effort ruled out at home to Germany after there was an offside in the build-up.

Assuming Paddy McNair will start regardless of Ballard's injury, O'Neill has a number of options available to him.

Norwich City's Ruairi McConville is the most likely replacement for Ballard in Bergamo.

The 20-year-old was also an injury doubt but played the full 90 minutes of the loss to Southampton on Wednesday, and again in Saturday's win over Charlton Athletic.

He made his debut in 2024 and has won nine caps, and has been a regular for Norwich since breaking into the first team in November.

Another option at centre back is Eoin Toal, who started the World Cup qualifier in Germany.

The Bolton Wanderers captain has helped the club to third in League One, and has won 10 caps.

Oxford United's Ciaron Brown has often been used as a reliable back up for O'Neill when others are out injured, and is a natural left-sided centre back.

He possesses a long throw and has scored twice in his last six matches for Oxford, so is a threat at both ends of the pitch.

Tom Atcheson has been called into the squad as Ballard's replacement from the Under-21s and is a know quantity to O'Neill, who is his manager at Blackburn Rovers.

Atcheson, 19, was named man of the match in Saturday's goalless draw with Championship front runners Middlesbrough.

There is some flexibility as to how Northern Ireland could line up in Bergamo, despite missing Bradley and Ballard.

Bradley would likely have started the game at right wing-back, using his energy to drive up and down the pitch.

While losing Bradley was a blow, it is a position that Northern Ireland have strength in depth with Trai Hume, Brodie Spencer, Terry Devlin and even Ethan Galbraith able to play there.

Of Northern Ireland's last 10 fixtures, either Ballard, Bradley, Hume or Justin Devenny - O'Neill's four Premier League players - have been unavailable for seven of them.

Here is how O'Neill has played his back five in their absences:

The big question is about what to do with Trai Hume.

Do you play him at right back as a natural fill for Bradley, or shift him into the centre to replace his Sunderland team-mate Ballard?

If it is the latter, then it would not be a surprise to see three centre backs of Hume, McNair and McConville, with Devenny on the left and either Spencer or Devlin at right back.

If O'Neill opts to play Hume at right back, then McNair would be the old head alongside two of the less experienced options that we mentioned above.

Regardless of who steps in, losing two of the four players who have played in the Premier League this season is a huge blow to O'Neill, and others will have to step up to fill the void if Northern Ireland are to achieve their World Cup dream.