Manchester United have launched an investigation into their first team injury crisis and cited it as a significant factor behind their torrid start to the season.

Erik ten Hag has been without as many as 16 senior players at different junctures already this season.

The United manager currently has eight of his squad missing, including his entire first choice defence of Lisandro Martinez, Luke Shaw, Raphael Varane and Aaron Wan-Bissaka.

It has meant Ten Hag, who has been given staunch public backing from United’s hierarchy, has been unable to pick his first choice XI at all this season.

United believe that situation has played a role in their struggles so far, with the club currently10th in the Premier League and already facing an uphill battle to qualify from their Champions League group after losing their first two matches.

Now the club have begun an internal probe to determine why so many players have suffered injuries and to establish whether any patterns exist that warrant changes to their approach to improve injury prevention in the future.

The highly respected Gary O’Driscoll took up his new role as head of sports medicine at Old Trafford last month after 14 years at Arsenal and United believe the cumulative toll of matches for club and country is a factor behind the problems and note that other clubs have suffered similar issues.

Like United, rivals Manchester City have suffered a raft of injuries to key players as well, including Kevin De Bruyne who is uncertain to play against this year, and it is not considered a coincidence that both clubs played the most games of Premier League sides last year.

United, for example, played 41 games between December 21 and the end of season alone, the same number Aston Villa, Brentford and Brighton played over the entirety of the campaign.

All told, Ten Hag’s side played 62 matches in a season when they also had 15 representatives at the winter World Cup in Qatar.

“We’re also looking at why we’ve had so many injuries to see if there’s any patterns to improve prevention in future,” John Murtough, United’s football director, told the club’s latest fans’ forum on Tuesday.

“Some of them have been impact injuries such as Kobbie [Mainoo] and Amad [Diallo], which are unpredictable. Others have been muscular and could reflect the sheer volume of games played over the past year, including last year’s World Cup.

“That’s certainly an issue we are aware of and will continue engaging through our governing bodies and the ECA [European Club Association] to ensure that player welfare is considered as part of discussions around the football calendar.

“We are engaged with governing bodies regarding the number of games across the year to ensure the schedule remains sustainable.”

With the European Championships to follow this season and then Fifa’s new 32-team Club World Cup to take place at the end of next season, United – like many other leading clubs – fear the situation could only worsen over the next couple of years.

Pep Guardiola, the City manager, suggested this month that it was only the players who could force meaningful change and United’s hierarchy are understood to share that view. Raphael Varane, the United defender who is currently sidelined by injury, has been a vocal critic of the increasing demands being placed on players but claimed their concerns are not being heard by the game’s decision-makers.

Murtough said United’s injury woes offered “strong mitigations for the mixed results” as he gave his complete backing to Ten Hag and expressed confidence that the Dutchman would turn the situation around.

United scored twice in four minutes of stoppage time to beat Brentford 2-1 last Saturday and Murtough hopes it proves a turning point in the season.

“Clearly, we’ve got work to do to get the men’s team back up to the levels we expect, but we really believe in the manager, his staff and the players, and their ability to build momentum as the season progresses,” Murtough said.

“It’s been a disappointing start to the men’s season, although Saturday’s dramatic win against Brentford has given us something to build on after the international break.

“Now, we have to show that same drive to turn the season around after the international break and I know that the manager, players and staff are absolutely determined to do that.

“There’s still three-quarters of the campaign to go and four competitions to compete in, so it’s important we keep our belief — both within the club and among the fans.”