Flintoff's surgery places the focus on ECB medics

Twelve weeks or 12 months? England are desperately hoping that Andrew Flintoff's recovery from surgery on his injured left ankle fits in to the first of these two timescales, because without their most inspirational and formidable player there seems little chance of the team retaining the Ashes this winter.

Yet those who are overseeing this week's operation on Flintoff, and are responsible for his rehabilitation, are aware that an injury like his can take far longer to heal. Glenn McGrath, the Australian fast bowler, was out of action for almost 12 months after having a similar operation on his ankle in 2003 and, for a big man, he is very light on his feet.

Removing the scar tissue created by an operation to displace a bony growth in the early part of 2005 sounds fairly routine but the left ankle is a crucial part of a fast bowler's anatomy. Flintoff sends seven or eight times his bodyweight through the joint with every ball he bowls, stress that is bound to cause pain when there is a defect.

The handling of Flintoff, along with that of Michael Vaughan, Simon Jones and Ashley Giles, who were advised to rest before undergoing surgery, has put the medical set-up at the England and Wales Cricket Board under the spotlight. Specialists are, understandably, cautious about operating straight away, and prefer to give the patient another course of treatment before placing them under general anaesthetic. But, in the last two years, each of these four players has had an operation that has failed to correct their initial problem.

Should Flintoff's rehabilitation go according to schedule, and he is fit to bowl by the middle of October - five weeks before the first Test in Brisbane - England then have to get him playing cricket. Being fit is an issue but regaining the form and match fitness required to take on Australia is another.

Jones, Giles and James Anderson, who still harbour hopes of playing in the Ashes, are in a similar position and, somehow, the ECB will need to get them playing competitive cricket well before the squad travel Down Under on 5 November. "We're investigating areas where they can play cricket," said David Graveney, the chairman of selectors. "South Africa is an option, Australia is another. Maybe the Australians might allow some of our players to play in their state cricket, that would be an interesting development, or is that a bit too mischievous?"

Graveney's desire to get Australian state sides to help England's cause may be a trifle optimistic. States in Australia, unlike those in England, tend not to play overseas cricketers, but there is every chance that a few Grade teams - club sides - will. Grade cricket in Australia is of a very high standard and it would give England's injured players the desired workout.

Deprived of Flintoff, England yesterday named a 14-man squad for Thursday's second Test against Pakistan in Manchester. Andrew Strauss retains the captaincy and will do for the rest of the four-Test series, and Jamie Dalrymple has been called up. The Middlesex off-spinner will only play if the Old Trafford pitch looks like it will spin.

"I thought Jamie Dalrymple did really well in the one-day games [against Sri Lanka] and I've always been impressed with him," Graveney said. "When things aren't going well he gets in there and battles away. He's just starting his career and his selection is to give Duncan [Fletcher] and Andrew enough options when they look at the pitch."

There is likely to be one change to the side that drew with Pakistan at Lord's. Liam Plunkett is in the squad but the side strain he sustained while playing for Durham on Saturday looks set to rule him out. Sajid Mahmood and Jonathan Lewis will compete for the Plunkett's place with the former expected to be given the nod on his home ground.

Ian Bell, a centurion at Lord's, will retain his place and add depth to the batting, but the challenge for England is taking 20 Pakistan wickets. The return of Younis Khan, a player with an average of 48, and the loss of Flintoff will make that much harder.

England squad (Second Test v Pakistan, Old Trafford, Thursday) A J Strauss (capt), M E Trescothick, A N Cook, K P Pietersen, P D Collingwood, I R Bell, G O Jones (wkt), S J Mahmood, M J Hoggard, S J Harmison, M S Panesar, J W M Dalrymple, J Lewis, L E Plunkett.

The problem with Freddie's action

Flintoff's problem is caused by the position in which he places his foot when he bowls, writes Angus Fraser. The left foot of most right-arm bowlers is placed flat on the ground and points down the pitch towards the batsman as the ball is delivered. Yet Flintoff initially lands on his toes with his foot pointing towards fine leg.

He then twists it straight as his right arm comes over to bowl, a movement that places a huge strain on a tendon at the back of the ankle. And it is this motion, rather than the tiny fragments of bone in the joint - the diagnosis incorrectly given by the England and Wales Cricket Board after the Trent Bridge Test against Sri Lanka - that is the root of Flintoff's injury.

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