A season of upheaval at the wrong end of the English Premier League. An unrelenting daily grind for playing time – and basic respect as a professional, even – on the training ground and in the locker room. A puzzling and distressing gap between his powerful form in US national team colors and his pedestrian output on club duty ... and all of it happening just before the world's biggest tournament.

Jozy Altidore has been here before.

In fact, the Sunderland man found himself in a nearly identical spot four years ago, when his first EPL experience – a year-long loan to Hull City from Villarreal, the club that still owned his rights at the time – ground to a discouraging halt in the lead-up to the 2010 World Cup in South Africa.

Phil Brown, his manager at Hull, was sacked that March as relegation loomed. Sunderland pulled a similar trigger early on in the current campaign, dismissing Paolo Di Canio, the man who'd arranged for Altidore's pricey transfer from Dutch club AZ Alkmaar, last fall. Both bosses were equal parts charisma and eccentricity, depending on your perspective, and neither appeared to leave Altidore with much of a legacy to build upon.

Just as Hull City languished in the relegation places right from the start in 2009-10, Sunderland are in grave danger of falling through the trap door to the Championship and have been since late summer.

And after initially finding a warm welcome at both clubs, Altidore subsequently bore the brunt of fans' frustrations when his personal scoring struggles came to epitomize his respective teams' overall ineffectiveness in the unforgiving environs of the world's richest league.

Back then, Altidore experienced the jarring shift from hero of the USA's stirring 2009 Confederations Cup run to misfiring underachiever; this time it was a quick comedown from his tremendous Alkmaar career and a prolific run in his country's imperious march to World Cup qualification.

His current ordeal may well have bottomed out this week, as he was left off Sunderland's 18-man game-day roster and sent down to the Black Cats' U-21 side instead, where he did not find the score sheet in a 3-0 win over Tottenham Hotspur's juniors.

Of course, it's hardly the situation USMNT coach Jurgen Klinsmann would want for his first-choice front man two months before Brazil 2014 kicks off. Just a few weeks ago Klinsmann was advocating for Altidore to aim for a move to a UEFA Champions League club, a suggestion that inspired dark humor among Sunderland supporters who've seen just one EPL goal out of one of last summer's showcase attacking acquisitions.

In particular, a fiendishly impatient environment and wavering commitment levels from his coaches seem to have given Altidore a torrid time in England, contrasting starkly with the supportive air that surrounds his place on the US squad.

In his country's colors, Jozy is respected, valued and needed, even when he suffers through extended droughts like the year-and-a-half gap between US goals from November 2011 to June 2013.

Even when Klinsmann briefly dropped him from the squad, it soon became clear that the move was for motivational reasons and Altidore's positive response quickly earned praise, and a recall to the lineup. He would become an unstoppable force in the march to qualification last summer.

Did the big target man and his representatives simply pick the wrong clubs on these occasions? Or is there something to life in English soccer that keeps him from showing his best?

And how will all this impact his abilities when he dons a USMNT kit this summer?

For some, the relegation threat is a crushing weight around the shoulders. Yet others use it as an opportunity to be seized – like Altidore's usual US strike partner Clint Dempsey (at right) did shortly after his arrival at Fulham FC in 2007, scoring a pivotal goal against Liverpool to keep the Cottagers in the top flight and set himself up for a hugely successful career at the club.

Gus Poyet's recent treatment of Altidore suggests that he'll have a hard time even making the Uruguayan gaffer's game-day roster, much less being entrusted with important minutes as the Black Cats make their last stand this spring.

Both player and coach will have to bear a share of responsibility for that, though in the eyes of many observers, EPL clubs' cutthroat and generally transactional approach to management absolves Poyet of any proprietary duty to help his 24-year-old American forward improve.

So now it's up to Jozy to find some sort of redemptive value from a painful year which may have destined him for another move, to the seventh club of his European career. He did as much four years ago, when he started all four of the USA's World Cup matches despite his Hull hell.

And in a few weeks, perhaps Klinsmann can help him out in person. Unlike his club coaches, the USMNT's top man has gone – to borrow a slogan from the company that manufactures the striker's preferred footwear – all in on Jozy.