Ben Stokes will have an MRI scan on Tuesday to determine the extent of the right calf injury which cast a shadow over England’s push for a series-levelling victory at Old Trafford.
The England and Wales Cricket Board confirmed Stokes will go for the scan after the pivotal all-rounder pulled up mid-over on the fourth afternoon against Pakistan in the second Test.
His absence - confirmed shortly afterwards by England - from the remainder of Monday’s play in the first instance, is a significant blow in both the immediate and more medium term.
The 25-year-old has already missed two Tests, and a limited-overs series, against Sri Lanka this summer because of knee surgery.
It was at Headingley in May that Stokes injured himself for the first time this season, and after his operation and a period of rehabilitation he was able to return for this second match of four.
He bowled 25 overs and took two wickets in the first innings in Manchester but had bowled only 5.2 more when injury struck again.
Stokes left the field immediately, in obvious pain.
It was a measure of his own concern and frustration that he was seen banging the dressing room door behind him after limping off.
England are due to name their squad by the end of this week for the third Test at Edgbaston, which begins next Wednesday.
The fourth and final match of the series follows at The Oval.