An ankle operation is keeping the Club America midfielder out of the World Cup, which represents a blow to Miguel Herrera's side.
The Club America player – who is currently on the transfer list at the club – was a central figure in the club’s successful run to the final of both the Clausura and Apertura of 2013 under Herrera.
The 30-year-old glues the midfield together, moves the ball forward when he receives it and patrols the space in front of the defense with aplomb for Herrera.
Most of all, he knows Herrera’s 5-3-2 system inside out and exactly what is required from the defensive midfield position.
The best example of that was last month in the friendly against the United States in Phoenix, Arizona, when the Stars and Stripes stormed into a 2-0 halftime lead. Holding mid Jesus Zavala looked lost in a system that was alien to him and Michael Bradley ran riot.
At halftime, Medina was brought on and shored up the side, stemming Bradley’s influence and radiating confidence in his teammates.
It looked like being the defining moment in Medina consolidating his place in Herrera’s starting XI for the World Cup, but the news Tuesday that an operation on his right ankle is necessary and he’ll miss Brazil 2014 is a bitter blow to both the player and his coach.
The fact left wing back Miguel Ponce is his replacement makes sense after his positive season with Toluca, but it also leaves Mexico short in midfield.
The most obvious option to replace Medina in the starting XI would be Jose Juan “Gallito” Vazquez, who plays the same holding role for champion Leon as Medina has for Las Aguilas.
Vazquez is coming off the back of a superb playoff run, is in form and plays week in, week out with fellow national team players Carlos Pena and Luis Montes in front of him. It could be tempting to simply transfer the heart of that successful Leon side to the national team.
The major doubts over Vazquez are that he has played very little outside of Mexico and is unproven on the world stage, although he has deserved at least a shot at the position with his recent play.
A tantalizing alternative could be Porto’s Hector Herrera.
The 24-year-old has had a positive first season in Portugal, has a smart footballing brain and would make a mouthwatering combination with Pena and Montes.
But there is a major downside to Herrera, which is that contención isn’t his natural position and El Tri would be losing out defensively.
Carlos Salcido could provide that steel in the center, but doesn’t have any of the dynamism and ability to start attacks that are other key components of the position with Herrera in charge.
The other option is Diego Reyes, who has played as a defensive midfielder previously, but not recently and moving him up from central defensive would likely mean slotting the out-of-form Francisco “Maza” Rodriguez into the defense.
In short, there is no easy answer. Medina’s absence leaves Herrera with a headache that he’ll have to find the solution to in the four friendly matches between now and El Tri’s World Cup opener on June 13 against Cameroon.