Manchester City striker Mario Balotelli hoping to avoid knee operation by having treatment in America

Manchester City have sent Mario Balotelli to a Vermont-based knee conditioning specialist in an attempt to resolve the injury that has forced the Italian forward to miss three months of the season.

Knee problem: Balotelli's injury issues have been a concern since his debut for the club, arguably even more than his taste in hats. He was sent to Vermont to sort out the injury. He probably hated it Credit: Photo: ACTION IMAGES

Balotelli, who underwent surgery on a damaged meniscus cartilage in September, is due to spend another week at Bill Knowles’s remote Killington Medical Clinic having flown to the United States last Friday.

Knowles, described on the clinic’s website as having “helped professional and Olympic level athletes recover from season-ending and career-threatening injuries”, has also worked with Manchester United and Chelsea, as well as overseeing the rehabilitation of England rugby players Jonny Wilkinson, Charlie Hodgson, Richard Hill and Austin Healey following knee injuries.

Balotelli has not played for City since scoring a hat-trick in the 4-0 victory against Aston Villa on Dec 28 and, although manager Roberto Mancini remains hopeful that the 20 year-old will be fit to face Manchester United at Old Trafford on Feb 12, surgery has not been ruled out and a decision on the next step is likely to be made once he returns from Vermont a week on Friday.

“Mario has gone to Vermont,” Mancini said. “He’s gone out there to work and to improve his knee.

"The surgeon has said he doesn’t need the operation and I hope that he doesn’t need an operation. But if he does, it will be a problem for us.

“In these two weeks he must work hard in Vermont. We hope that, when he comes back, he will be ready to play.”

Balotelli suffered from knee problems with Inter Milan, prior to his £22 million move to City last summer, but his current injury is understood to date back to one suffered on his debut for the club in the Europa League against Timisoara in Romania in August.

Surgery in Italy forced Balotelli to miss nine weeks of football and he is now approaching a month out of action following his latest setback.

But with Killington offering little in the way of distractions beyond a supermarket and a ski slope, Mancini is hopeful that Balotelli will be able to focus fully on his intensive rehabilitation work with Knowles.

“In Vermont, Mario can work quietly without a problem.” Mancini said. “Without the pressure that he has here, he can work without any problems.

“He arrived and he had a problem, so he has never been 100 per cent while he’s been here.

"He has improved with games, but for Mario, it’s important to start to play regularly, then he can show the supporters he’s a good player.

“Can he play against United next month? Yes, maybe. But it’s more important that when he comes back he can play in all the games for the rest of the season. I think he can come back and play in the next four weeks.”

Balotelli’s tendency to court controversy remains as potent as ever, though, despite his trip across the Atlantic.

The outspoken striker claimed earlier this week that Wayne Rooney was “not the best forward in Manchester” but Mancini insists that Balotelli is entitled to speak his mind, regardless of the consequences.

Mancini said: “I have not read the interview so I don’t know what he said, but I know he likes to joke sometimes.

"Mario has fantastic talent. He has everything he needs to be one of the best strikers but he needs to improve and work and show all these things.

“But it’s a free world and if he wants to speak, then he can speak. If somebody wants to say something then it is better that he says it.

“This is not the SS. It’s not like the war when we couldn’t speak. If you want to say everything then you can say it. But it is important that he shows his talent and, for his future, it’s important that he improves.

“At the moment this is the best league in Europe, so this time is very important for him.”