Should Freddie now be fearing for his future?

The 29-year-old all-rounder was aiming to play for Lancashire in their LV County Championship match against Sussex at Hove, which was due to start yesterday, but he failed a morning fitness test. A 30-minute spell of bowling in the nets the previous evening had prompted renewed discomfort.

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Given that he had already missed the first two npower Tests against West Indies due to an inability to bowl flat out, the England medical staff, in conjunction with their Red Rose county colleagues, realised they had run out of options. A commendably swift decision was made to send Flintoff for surgery.

Once that has taken place, the all-rounder will be assessed next week to establish a timetable for his rehabilitation. Two previous operations on the ankle resulted in lay-offs of around three months, but this time the pain is being caused by a problem at the front rather than the back of the ankle, as was the case before.

In a statement yesterday, Dr Nick Peirce, the ECB's chief medical officer, said: "Despite intense conservative treatment and rehabilitation, Andrew's ankle has continued to cause him discomfort when bowling at full capacity. As a consequence, he will undergo an exploratory arthroscopy. The recovery period is not expected to be as long as after Andrew's previous surgery."

Flintoff said: "I'm bitterly disappointed to face another operation on my ankle. The rest and rehabilitation appeared to be helping but after giving it a strong work-out this week, it seems that an operation is the only option.

"Having bounced back from ankle surgery before I know how much work is ahead of me but I'm desperate to get back playing for England as soon as possible."

The injury is thought to be an anterior impingement, known as Footballer's Ankle, where soft tissue becomes thicker than normal and pinches between the bones, causing pain, inflammation and swelling. Either that or Flintoff's bowling action may have caused a bone spur to develop at the front of his left ankle, which bears the full force of his delivery stride.

Medical experts suggest that, following an operation, normal activities' are possible in around six weeks. Nobody would argue that bowling a cricket ball at 90mph is normal', so Flintoff will be looking at a break of around two months. Should he recover quickly, the final Test against India at The Oval on August 9- 13 could be the target, but the subsequent one-day series would appear a more realistic possibility.

Yet, the big concern must be that Flintoff 's body cannot stand up to the demands of his all-action game. Each operation has been followed by a period of respite, then the pain resurfaces.

Having surgery three times on the same area of the body is not normally advisable, although Michael Vaughan is back as national captain despite having his knee repaired four times.

The devastating truth for the country's cricketing icon is that doing what he does best is bad for his health. England wouldn't pick him as a batsman alone, as the runs have dried up. But he has emerged as one of the best fast bowlers in the world and could justify his place in the Test team as a seamer alone but for his ankle.

For the man whose efforts were the primary reason for England snatching the Ashes from Australia in 2005, a sense of dread would be understandable. When all his best efforts to stay fit come to nothing, he must see the day fast approaching when he is reduced to flogging county bowling attacks as a Lancashire batsman.

For national coach Peter Moores and his fellow selectors, the worries are equally profound. What if the talisman never fully recovers? How can you replace a player who can bowl like a hurricane, smash the ball into neighbouring counties, hold slip catches in his sleep and un-nerve even Australia with the force of his will?

There are, of course, no like-for-like replacements.

For now, England can cope without Flintoff. But Kevin Pietersen spoke on Monday of the team's desire to make opponents fear them and that is what the mighty all-rounder does more than anyone.