Mark Wood is set to miss England's tour of India after the news he will require a third ankle operation in 12 months.
The fast bowler has not played Test cricket since last October, but featured in four of the one-day internationals with Pakistan during their recent tour of England.
Having already been ruled out of England's ongoing tour of Bangladesh, it has now been discovered Wood fractured a bone in his left ankle while bowling for Durham against Surrey in the County Championship last month.
"Woody showed his commitment to Durham with the way he bowled 35 overs in that Surrey game, and we know now that he also showed a hell of a lot of courage and resilience," England's national physiotherapy lead Ben Langley said.
"His foot and ankle swelled up hugely during the game, which was obviously worrying, and then we were perplexed when nothing significant showed up on the first scan.
"It was only when we got him in for a second scan that we discovered he'd been playing on despite having fractured a bone.
"So it's a different injury to what he's had the previous surgery for, and there's no reason to think that when he's had this bone fragment removed, he won't be able to get back to bowling as well he has for Durham, England Lions and England in the second half of the 2016 summer."
England face India in a five-match Test series, which starts next month, before a pair of three-match one-day series and a Twenty20 series of the same length.