England fears over KP Ashes fitness

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The former England captain was surprisingly ruled out of Friday's humiliating ICC World Twenty20 defeat to Holland at Lord's after suffering a recurrence of the problem which has plagued him since this winter's Caribbean tour.

He has received treatment for the last two days and an injection to try and accelerate his recovery and ensure his availability for Sunday's crunch match with Pakistan at the Oval. But having already rested him for the one-day series against West Indies to try and ensure his fitness for this tournament, England are now anxious that only several months off will cure the niggling problem.

"They are terrible injuries," confirmed England coach Andy Flower. "I had an Achilles problem for about five years when I was playing and they are very difficult to get rid of.

"They can hang around for a long time and with our schedule you don't get huge chunks of time off. I think you need months off to get rid of those sort of problems altogether."

England start their Ashes challenge in just five weeks' time at Cardiff and are already concerned about whether all-rounder Andrew Flintoff will have recovered from a knee operation over a month ago.

The additional loss of Pietersen would be a further blow to England's ambitions later this summer, and Flower has admitted he sought medical advice before the start of this tournament to determine whether England's best batsman would be best served by resting rather than playing.

"Leading up to this tournament, I specifically asked for the medical advice on that because if it had suggested we rest him during this period leading up to five Test matches against Australia, we would have done so," added Flower.

"The medical advice was that we didn't need to do that and they could manage it through a Twenty20 tournament, but I don't necessarily think that advice was wrong because these injuries are very difficult to manage and having a three-week rest might not necessarily do the business."