West Ham defender Aaron Cresswell has been ruled out for up to four months with a knee ligament injury.

The 26-year-old left-back was hurt in Saturday’s pre-season win over German side Karlsruher in a heavy challenge that infuriated his team-mates.

Cresswell is seeing specialist “early next week”, according to the club. At that point a decision will be taken on whether surgery would be required.

The left back, who joined from Ipswich in 2014, has been a consistent favourite of manager Slaven Bilic, playing 37 league games last season.

Club medical chief Stijn Vandenbroucke said : “Whatever course of action we decide to take, Aaron faces a period of rest, followed by treatment and rehabilitation and he will be out for a period of between three and four months.”

But that’s not the end of Bilic’s injury worries ahead of the first competitive match of the season – the Europa League qualifying tie against NK Domzale on Thursday (July 28).

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Influential playmaker Manuel Lanzini who suffered a knee injury at the weekend in Argentina’s 2016 Rio Olympic Games warm-up fixture with Colombia at the weekend.

Vandenbroucke said: “We are in close contact with Manuel and the Argentine Football Association, who have started a late-release replacement procedure with the International Olympic Committee.”

“Until he has been assessed by the IOC, he cannot be replaced, but after this process has been completed we want him to return to England to be assessed by our own medical staff as soon as possible.”

The club is currently in Austria preparing for the third round qualifying tie against the Slovenian team and pushing themselves hard to get up to peak fitness.

They were joined by Reece Oxford, back from England U19 duty, and on the back of a summer where he has been linked with a move to another Premier League club.