Danny Welbeck’s participation in England’s opening World Cup game against Italy has been left in considerable doubt after he limped out of the squad’s training session on Tuesday, with Raheem Sterling’s chances of starting in Manaus enhanced as a result.

Welbeck, who was already wearing heavy strapping on his right thigh, was led away for treatment by the head physio, Gary Lewin, while the players undertook attacking drills at their plush base at the Urca military camp. His absence from Saturday’s game would constitute a considerable blow for Roy Hodgson, who has leant heavily on the Manchester United forward throughout his tenure as manager despite his relatively meagre goals return for his club.

The 23-year-old, who has scored a solitary goal for club and country since 11 January, has found the net eight times in 20 games under Hodgson, including five in 12 competitive contests for the manager, and he had been pencilled in to operate on the left of an attacking trident – deployed behind Daniel Sturridge – after a relatively impressive display in the goalless friendly draw with Honduras in Miami on Saturday. His pace and willingness to work in defensive areas are valued by Hodgson.

Sterling was heavily involved in Tuesday’s session, employed for long periods in the central role of the trident just behind Sturridge, with Wayne Rooney, Adam Lallana and James Milner interchanging in the wider positions. He would have started Saturday’s draw at the Sun Life stadium , most likely in the centre, only to be ruled out through suspension having been sent off against Ecuador in midweek only 13 minutes into his fourth cap for a reckless challenge on Antonio Valencia.

Facebook Twitter Pinterest A behind-the-scenes view of England in training

The Liverpool player has had only 39 minutes of football in the past month, though Hodgson would have no qualms about handing him a competitive start against the Azzurri. “Any time you choose to select or not select a player, you can come up with reasons,” Hodgson said. “If you’re asking me will I hide behind that, to not consider him, then no I won’t because he’s as fit as a flea and I’m pretty certain he hasn’t forgotten how to play matches, either. It was unfortunate that he couldn’t play against Honduras but I can tell you that Raheem Sterling is very much in the group of players I’m considering.

“If I select him, it won’t be in my opinion a risk that he hasn’t played so many minutes. And if I don’t select him, it certainly won’t be because he has only played 39 minutes. It will be because I prefer someone else. That’s all I can tell you.”

Alex Oxlade-Chamberlain, who damaged the medial ligaments in his right knee during the 2-2 draw with Ecuador, was again at the training ground maintaining his fitness with a view to being available for England’s second group game against Uruguay in São Paulo. The Arsenal winger was not wearing a brace on the knee as he again undertook running drills. Hodgson does not intend to call up either John Stones or Jon Flanagan to replace the midfielder. “It looks very unlikely that we’ll replace Alex,” he said.

England can technically make a change up until 24 hours before the Italy fixture. “I don’t think that will be the case. I’m not a doctor, I can’t give you real up to date or detailed information about where it is. But he has got a strained medial ligament, that we do know. He is certainly working very hard and I don’t think he could be further forward in terms of his progression than he is now. It’s very promising that he can run so well already. We’ll be stepping up his training programme during the course of the week.”