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Spain's Sergio Ramos must resolve shoulder issue - Vicente del Bosque

Spain coach Vicente del Bosque says Real Madrid defender Sergio Ramos should sort out his shoulder injury properly, amid a possible club vs. country row over whether an immediate operation is required.

Ramos, 29, dislocated his left shoulder during September's Champions League game with Shakhtar Donetsk. He then missed Spain's Euro 2016 qualifiers against Ukraine and Luxembourg, but played a number of Madrid games with a pain-killing injection before the joint had recovered completely.

That plan appeared to backfire when the centre-back again hurt his shoulder in last weekend's 3-2 La Liga loss at Sevilla, leading him to allude to personal issues with Madrid's medical staff and to again pull out of Spain's squad ahead of friendlies against England and Belgium.

Reports have suggested the plan now is for Ramos to play in Nov. 21's Clasico against Barcelona, and then decide whether to operate immediately or wait and see how the issue develops.

This, however, could then bring the risk of a more serious problem which could endanger his participation at Euro 2016.

Del Bosque told a news conference that it was important for the problem to be properly sorted and not left unresolved until next summer.

"If he cannot play with us now, the important thing is that he gets better for his team," he said. "And that he is fine for June. We do not need Sergio Ramos again until March."

Madrid playmaker Isco also pulled out of the Spain squad this week, meaning that Los Blancos now have just one player with La Roja -- back-up defender Nacho Fernandez -- compared to five Barcelona representatives.

Madrid have not released any official details on the current state of Ramos' shoulder, with the Andalucian barely being mentioned in Thursday's fitness update.

"Real Madrid carried out their fourth and final training session of the week," the statement read. "The Whites, once again without the seven players that are on international duty, completed a demanding session out on pitch three at Real Madrid City. Keylor Navas, Marcelo, Sergio Ramos and Isco worked at the indoor facilities."

That quartet are expected to be in contention for selection for the clash with Barcelona next week.

Key players including Cristiano Ronaldo, Gareth Bale, Toni Kroos and Luka Modric have been excused from international duty this week -- a help for Madrid coach Rafa Benitez's pre-game preparations.