Manchester United interim manager Ralf Rangnick defended his medical team after Roy Keane questioned Cristiano Ronaldo's absence for Sunday's crushing 4-1 derby defeat to Manchester City.

Reports late on Saturday suggested Ronaldo would not feature at the Etihad Stadium on Sunday, with Rangnick confirming before kick-off that the Portugal forward was suffering from a hip problem.

United were also without Edinson Cavani, who was missing for a sixth consecutive game due to injury as they fell to a humiliating loss at neighbours City.

Former United captain Keane, speaking on Sky Sports before the game, suggested Ronaldo's omission may be down to other reasons after being left out for such an important fixture.

Keane insisted the decision did not "add up", with Rangnick citing a hip flexor problem that kept the forward out of training on Friday, and the German responded to the comments after the match.

"I have to believe my medical department," Rangnick told reporters when asked about Keane's thoughts on the Ronaldo situation.

"Our doctor came to see me Friday morning before training and told me that Cristiano could not train because of some problems with his hip flexor and the same was true on Saturday and that's why he couldn't be a part of the squad."

Rangnick appeared frustrated to be without Cavani once more ahead of the clash with Pep Guardiola's side, suggesting the Uruguay international ruled himself out of contention.

After the game, the former RB Leipzig boss again commented on Cavani being ruled out of the derby, insisting he could not make a player feature if they did not feel fit enough.

"What does it help if I tell you it is frustrating? It is just a fact. If players tell the doctor and the medical department they are injured and cannot play, I have to accept it," he added. 

"I cannot force a player to play if he's not available because of an injury."

Pressed for an answer on whether Cavani decides when he is available, Rangnick responded: "Edi trained in the last three days, he trained well but he still felt after those three training sessions yesterday afternoon that he is still not fit to play.

"This is a fact. As a manager, I cannot force a player if he does not feel fit enough or well enough to play.

"We have to be – and I am – happy with the players we have. This is clear. We lost two, if not three strikers since Christmas, everybody knows.

"But this is a fact and we have to deal with it. I am not complaining about that."

The defeat at local rivals City leaves United a point adrift of fourth-placed Arsenal, who were 3-2 victors at Watford earlier in the day and have played three games fewer.

But Rangnick wants to focus on his team's push in the Champions League and hunt for a place in England's top four in the coming weeks, despite continued questions over who will take over at Old Trafford when his short-term contract concludes.

"Look, I'm still the manager of this team for another 10 games in the Premier League and hopefully a few more games in the Champions League," he continued.

"It doesn't make sense now to start speculation about how many players would we need and in what positions, this is my issue.

"Right now it's about preparing the team for the Tottenham game and after that, for a very important game against Atletico [Madrid] in the Champions League."

Roy Keane called for Manchester United to dump their derby flops as he attacked "shameful" effort levels in the 4-1 defeat to Manchester City.

Along with fellow 1999 treble winners Gary Neville and Peter Schmeichel, Keane said the performance from United was unacceptable at the Etihad Stadium.

Doubles from Kevin De Bruyne and Riyad Mahrez left United to reflect on a wretched afternoon at the home of their neighbours.

A first-half strike from Jadon Sancho had briefly brought United level, as they began the game well enough before fading alarmingly.

Keane said on Sky Sports: "They did give up, and for a player in any game to give up, it's unforgivable really.

"The beauty of top-level sport is there's no hiding place. I know United have done well here the last couple of years. We saw all the United shortcomings today.

"There's ways to lose football matches. We've all lost football matches. But the way United lost it today, they stopped running, they gave up. There are players not running back, that's what I don't understand."

Ralf Rangnick, the interim manager, had led United on an eight-game unbeaten run in the Premier League before this crushing blow.

"The manager will be criticised, and the tactics," said Keane. "But players not running back when you're playing for Man United, it's really unacceptable, it really is. They threw the towel in, which is shameful.

"It's hard when you're out there and you're up against a really good team and they're keeping the ball and you can't get it back, but I go back to it, we see some of the goals and you've got to run back, you've got to tackle.

"United players have shown quality over the years but we've just seen a reflection of where the team is and where the club is. It's just so far behind the other teams."

Sunday's results saw United slip to fifth, as Arsenal went above them with a 3-2 win at Watford earlier in the day.

Keane suspects there is more to United's troubles than may meet the eye, casting a degree of doubt before kick-off on the reason for Cristiano Ronaldo's absence, which was put down to a hip problem.

But he sees no excuse for United's players letting their focus drift.

"Whatever's gone in the dressing room, and we hear noises all the time, and we hear about problems obviously with the new manager maybe coming in, and recruitment," he said.

"But your own bit of pride eventually has to kick in at some stage. There were five or six players who should never play for Manchester United again. Just shameful, shameful that you can't run back and put your body on the line.

"I thought City had a couple of gears to go. They toyed with them. They [United] gave up, and shame on them."

Schmeichel, speaking on BBC Radio 5 Live, felt United were ripe for being picked off and need to look at themselves.

The former goalkeeper said: "I thought Rangnick should have changed things at half-time. He may have had words, but the second half was worse; at no point were United in the game apart from on the scoreline.

"Far too many players are either not good enough, or don't care enough. Having an interim manager means he can't do much; he knows he's not going to be there, so what can he change?

"There are players whose contracts are running down. [Paul] Pogba started the game, big question marks over whether he's going to stay. [Substitute Jesse] Lingard has said he doesn't want to be there. But for all that, Man City showed, in difficult circumstances, that they are the best in the country."

Roy Keane has questioned why Cristiano Ronaldo was omitted from Manchester United's squad for Sunday's derby showdown with Manchester City.

Ronaldo leads the scoring charts for United this term with 15 goals across all competitions, but he played no part against Premier League leaders City at the Etihad Stadium.

Ralf Rangnick put the Portugal international's absence for the contest down to a hip flexor injury that kept him out of training on Friday.

But former United midfielder Keane suggested there may be other reasons behind the five-time Ballon d'Or winner being left out by Rangnick for such an important game.

"There seems to be more to the Ronaldo story when a manager comes out and talks about a hip flexor... I don't get it," Keane told Sky Sports ahead of the match. 

"We talk about Ronaldo being a machine and very rarely getting injured but every now and again he comes out with that... a hip flexor? It doesn't add up to me.

"It's a surprise to hear Ronaldo has a hip injury but United have pace, quality. They still have important players and they still have to come out and play with pride."

Ronaldo had played in 30 of United's 37 games this term prior to the City game, a tally bettered only by Jadon Sancho (31), David de Gea (35) and Bruno Fernandes (36).

United had won 11 of the 20 Premier League games Ronaldo had featured in before Sunday, compared to two wins from the seven games he has not played a part in.

Luke Shaw and Raphael Varane also missed the City match after testing positive for coronavirus, while Edinson Cavani failed to recover from injury in time.

Gareth Southgate suggested pundits produce "quotable" takes to "stay relevant" after Roy Keane criticised Harry Maguire's celebration against Albania.

Maguire opened the scoring on Friday at Wembley, immediately racing to the corner where he cupped his hands beside his head before putting his fingers in his ears.

Former Manchester United captain and television pundit Keane criticised the celebration post-match, labelling the gesture as "embarrassing" considering the centre-back's recent club performances.

Maguire, however, remained adamant the celebration came "naturally" to him and was not about silencing critics, nor aimed at anyone in particular.

Southgate, who initially joked his defender's gesture was a wrestling reference, was again questioned on the topic and – while not naming Keane or Maguire – outlined pundits' tendency to work with headlines in mind.

"I think we always have to understand that, the industry we’re in, there are different roles, and in order to make a living in those different roles you’ve got to take certain approaches," Southgate said at Sunday's pre-match news conference ahead of the trip to San Marino.

"You have a choice about which type of approach you’re going to take [when working as a pundit].

"I was always thinking as an ex-player, ex-manager, recognising how difficult those things were, so I guess I had empathy for those that were stepping over the line to play and those that were in the dugout.

"It really depends on what you need to do to stay in work. Some channels or forums require headlines, some require a certain type of approach, everything's different. I understand that.

"To stay relevant in some of those fields, you've got to say things that are more quotable, and of course everything’s lifted now and used from the live broadcast for the next day’s headlines.

"Everybody in those shows knows that's how it works, and it fills a different part of our industry.

"Personally, as a manager, I get it and so be it. I'm sure the players might feel differently, they're younger and have less experience of those fields, but also they think [pundits] surely remember how difficult it was to play and probably didn't like it when they were criticised."

Jack Grealish has hit back at criticism following England's Euro 2020 shoot-out heartache against Italy, insisting he wanted to take a penalty.

Gareth Southgate's side lost 3-2 on spot kicks following three successive failures from 12 yards by Marcus Rashford, Jadon Sancho and Bukayo Saka.

The game had finished 1-1, with the teams unable to be separated in extra time after Leonardo Bonucci's scrambled effort midway through the second half cancelled out Luke Shaw's second-minute opener.

Much of the focus was placed on England's choice of penalty takers afterwards, with Southgate taking full responsibility for selecting who would step forward.

Rashford and Sancho were introduced during the dying minutes, while Arsenal teenager Saka had never taken a penalty in his professional career.

"If you're [Raheem] Sterling or Grealish, you cannot sit there and have a young kid [Saka] go up for a penalty ahead of you, you can't," former Manchester United captain Roy Keane told ITV.

"You cannot let a shy 19-year-old go up in front of you. They have a lot more experience, Sterling has won trophies, they had to get in front of the young kid and stand up."

Grealish tweeted in response to Keane, saying: "I said I wanted to take one!!!!

"The gaffer has made so many right decisions through this tournament and he did tonight!

"But I won't have people say that I didn't want to take a 'peno' when I said I will..."

Speaking at his post-match news conference, Southgate insisted Grealish and Sterling – who was one of England's standout performers with three goals and an assist during the competition – being omitted from the chosen five was based upon preparations on the training ground.

"I chose the penalty takers based on what we've done in training and nobody is on their own," he said.

"We've won together as a team and it's absolutely on all of us in terms of not being able to win the game."

Grealish made five appearances at Euro 2020, four of which came as a substitute. He provided assists for Sterling's early winner in the 1-0 victory over the Czech Republic and Harry Kane's header as England saw off Germany 2-0 in the last 16.