Barely a day has gone by in the run-up to the World Cup without a player seeing his dreams wrecked by injury, and the lengthening casualty list is as predictable as it is dispiriting.
A host of players, including Colombia striker Radamel Falcao, German midfielder Marco Reus and French winger Franck Ribery will miss out on Brazil, while others such as Uruguay striker Luis Suarez and Chile midfielder Arturo Vidal are facing a race to be fit.
Past experience suggests that those top players who are still standing when the competition gets under way could struggle to produce their best form after an exhausting domestic season.
"It's not surprising that many top footballers are either injured or unfit for the upcoming World Cup," Vincent Gouttebarge, chief medical officer for the World Players' Union FIFPro, told Reuters.
"The top footballers have been exposed during the whole season to a high workload due to training and competition, while recovery periods are scarce during a football season."
Back in 2002, research led by former Sweden national team doctor Jan Ekstrand found a direct relationship between the number of matches played in the run-up to the World Cup and the players' performances and injuries.
Ekstrand said that UEFA and FIFA had taken notice.
"Both FIFA and UEFA are very concerned about the health of the players and listening more and more to medical opinions," he told Reuters.
"But there are so many factors involved in making a match schedule and the medical factors is only one of those."
Gouttebarge added that the physical demands on players during the games themselves were growing.
"The intensity has changed, the number of sprints of 10 or 20 metres in order to press, or to defend," he said.
Over the last 10 years, players had also been doing more strength-building exercises, as Real Madrid forward Cristiano Ronaldo showed when he ripped off his shirt and exposed his rippling muscles after scoring in the Champions League final.
"Before, players just did running but now the gym is part of the training and if it is not well adapted, with time to recover, it can induce injuries."
FIFA has a four-yearly calendar to stipulate when international matches and competitions are played, however this is designed more to avoid club-versus-country clashes and places no limit on the amount of club football that should be played.
"There is no escaping the fact that better harmony between domestic, continental and international match calendars in order to limit the workload on players is an urgent priority," said Gouttebarge.
FIFPro said the issue could no longer be ignored and demanded that the players have a greater say in the running of the game.
"The ever-increasing demands being placed on the players is a critical debate," said FIFPro spokesman Andrew Orsatti.
"It is a question of football's fractured governance structure which allows such rights abuses to occur on a revolving basis.
"That the players are abused is a fact. It stems from not being central to football's decision-making structure. There is an administrative imbalance which overlooks the players and promotes a culture where there are insufficient checks and balances.
"Football in its current scandalous form is unsustainable."