Since arriving at the club, Danny Graham has struggled to form a partnership with Steven Fletcher. They've spent the majority of games failing to link up, fighting for the same space and leaving a poor Sunderland midfield even shorter of quality and numbers. 4-4-2 - at least with two similar strikers partnered in attack - simply has not worked.
Now Sunderland could face the rest of the season without top scorer Fletcher. Whichever way you look at it, losing a player who has scored exactly a third of his team's goals and whose personal record is better than one goal in every three games this season is a huge blow, especially to a side facing a relegation dogfight.
It could, however, be the making of Graham. Aside from the aforementioned problems he has had linking up with Fletcher, the Gateshead born striker has generally failed to impress in his time on Wearside thus far. His record at Swansea offers hope that he is better than his fledgling Sunderland career suggests.
Even if it is enforced by Fletcher's expected absence, a shift in tactics should benefit Graham. At Swansea, he was the focal point of a three man attack. His goal record for the Welsh side was an impressive one in three last season. If he is to regain that sort of form in a red and white shirt then introducing the formation Swansea employed in their maiden Premier League season could well prove to be the catalyst.
Sunderland looked briefly encouraging this season when O'Neill pushed Sessegnon and Johnson forward and closer to Steven Fletcher against Wigan. Although Sessegnon and Johnson are not the quickest of sprinters, they are dribblers, which is exactly the type of player Graham had flanking him in his first season in the top flight in the form of Scott Sinclair and Nathan Dyer. Of course, there is a lot more to tactics than formation alone and Swansea played a completely different style of football to Sunderland but it would at least be a starting point.
The system would involve a nominal front three as mentioned, which could easily transform into a 4-5-1 when Sunderland are defending, just as it did at Wigan. Crucially, it would beef up our rather meek, passive midfield, providing better cover for both the centre of defence and full backs. The recent defeat to QPR showed just how exposed the full back is when Sessegnon is played wide in a midfield four. Gardner was targeted throughout the game and given very little protection.
In fairness to O'Neill, the line-up against Norwich which paired Vaughan and Larsson in the engine room has worked previously, in the victory over an appalling West Ham side. Against the Canaries it was a disaster, with Sunderland failing to create anything of note against 10 man opposition. Although O'Neill is lumbered with the same mediocre midfielders no matter how many he fields, the additional numbers would at least help his team exert some control on a game. Whichever combination he goes for, three average players is better than two.
It remains a mystery as to why Alfred N'Diaye was dropped for the Norwich game and his athletic presence would have added something different. He should probably be the first central midfielder on the team sheet at present, if for no other reason than he is not a small player who dwells on the ball before playing it square.
Alongside him, perhaps Gardner could be moved into midfield, with Bardsley returning at full back. The former Birmingham City man has rarely impressed in a central role in his time with the club but then Sunderland have rarely used him in a midfield three. He is one of the few players to come out with much credit this season, putting in some decent shifts at right back. While the game has a tendency to pass him by when he is in midfield, he can at least strike a ball with conviction and power. In the absence of Fletcher Graham is going to need all of the help he can get.
Utilising the right combination of players is key. Larsson and Vaughan never looked like being a good permutation against Norwich and so it proved to be the case. A midfield of N'Diaye, Gardner and either Colback, Vaughan or Larsson would offer a better variety of passing ability, goal threat and athleticism.
All of this assumes O'Neill will opt for this formation. Alternatively, Sunderland could return to the 4-2-3-1 system employed by the Northern Irishman for the majority of the season, which has produced mixed results. When Sessegnon plays centrally as part of the three behind the main striker, there is an issue with getting bodies into the box. The Benin attacker has not been clinical enough this season whilst also having limited impact as a defensive presence. He has not created or scored enough to warrant inclusion in this position as it leaves Sunderland with effectively the same problems in midfield as 4-4-2 does, without offering much of an additional goal threat.
It may be that Sessegnon is not fit to play against Manchester United this weekend. In that instance, it could be tempting to use Wickham as a support striker to Graham. He has never looked convincing as a lone striker but when he has been used - usually as a substitute - alongside a main striker, he has impressed. There were definite signs of a partnership developing with Fletcher on the odd occasion they played together, which could be replicated alongside Graham.
The chances of that happening - even if Sessegnon is out - are slim and rightly so. Preferably, McClean would be brought onto the left and Johnson moved to the right or Larsson used further up the pitch as a wide player. If things are not going to plan, Wickham would be an ideal "plan B" to throw on from the bench.
The rest of this season is all about survival. That means grinding out results no matter how ugly the football is. 4-4-2 was meant to improve things but while the entertainment value has remained negligible results have gotten progressively worse. It's time to pack the midfield and take a must not lose attitude. With a new system, Graham's performance level should pick up and he is hopefully a goal away from returning to the form he produced in South Wales. It could be that losing Fletcher provides an unexpected turnaround in Sunderland's fortunes. An unlikely scenario perhaps, but not inconceivable.