Giles damaged the cartilage in his right hip playing for Warwickshire at Hove in April. The injury forced the spinner to miss England's two Test matches against Bangladesh and the NatWest one-day series but, after a cortisone injection and intensive physiotherapy, he returned to play his part in the Ashes success.
Surgery is always the last resort and Giles was hoping that the problem would disappear. But it has not. It has worsened and England's premier slow bowler has been left with no option but to have an operation.
The hip is a difficult joint to get into, and there are very few surgeons who perform hip arthroscopies. But Giles in the very capable hands of Richard Villar, a surgeon who has corrected similar complaints on many sportsmen in the past.
"The hip has become more troublesome as the tour has gone on," admitted Giles on the eve of the third Test. "We were able to manage it during the summer but it has been harder to do it over here. I had a second injection in the hip before coming to Pakistan and it does not seem to have been as effective as the first.
"We were hoping to manage it for a bit longer than we have but I have reached the stage where I need to get this sorted out. It is hard to know how much it has affected my bowling. You try not to make excuses because some days you don't bowl very well anyway. But you just have to try and blank it from your mind, even though getting over my right leg is a very key part of my bowling action. You start to feel very old when you are carrying injuries.
Giles will miss the five one-day matches against Pakistan but there is no way he could play in them and then hope to be fit for England's tour of India. England return to the subcontinent at the end of February and the tour heralds the beginning of a 19-month period in which Michael Vaughan's side will play virtually non-stop.
England play Test cricket at home two weeks after the two-month tour of India. The summer is followed by the Champions Trophy in India, an Ashes tour and the 2007 World Cup in the Caribbean. And when the World Cup finishes the players go straight into the 2007 season at home.
"We are allowing ourselves three months recovery time," Giles said. "Some say it could take six to nine weeks but we have spoken to several football physios, because it is a common complaint in football, and they have told us to allow ourselves three months.
"Surgery will involve going in, to either repair or whip out a piece of cartilage. There is also a little bit of a bone spur on the ball of my hip and he may have to shave that down because that my be the thing that is catching on the cartilage.
"I have worries, because there can always be complications when you go into a major joint. But it comes hand in hand with the job. You are always going to pick up injuries but if you want to perform at your best you have to get them done."Reuse content