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United States midfielder Johnny Cardoso has suffered what the club deemed a “high grade” sprain in his right ankle, his club Atlético Madrid said on Thursday. The injury casts the midfielder’s participation in the 2026 World Cup in serious doubt, with just five weeks to go until the tournament starts and less than three weeks to go until US head coach Mauricio Pochettino names his squad.

High-grade ankle sprains typically take at least a month to recover from, and often more. The US opens its World Cup campaign on 13 June against Paraguay in Inglewood, California. They will then also play Australia and Turkey in Group D.

Atlético said Cardoso was hurt in practice and will undergo rehab. The club did not give a timetable for his return. La Liga has four rounds left and Atlético is eyeing a top four finish after being eliminated by Arsenal in the Champions League semi-finals this week.

The 24-year-old Cardoso has 23 appearances for the USMNT since his debut in 2020. The most recent came in the March international window, where he played the first 45 minutes of the United States’ 5-2 loss to Belgium. A defensive midfielder, he has largely struggled to replicate the good form he has displayed at club level with the national team, but is thought to be a potentially key piece of the US midfield should he turn that around with weeks to prepare ahead of the major tournament.

Should he be unable to play at the World Cup, Pochettino will have a few interesting options at his disposal as he determines his midfield personnel. This could mean that the Seattle Sounders’ Cristian Roldan becomes more of a lock to make his second World Cup roster, with his versatility, experience and respect among teammates being points in his favor. It could also mean an elevation for Tanner Tessmann, who has played 12 times under Pochettino, garnering the 15th-most minutes among US players in that timeframe. Tessmann also has versatility in his favor, having recently been deployed as a center back in a three-man backline for club and country.