Leeds: England all-rounder Andrew Flintoff will meet his surgeon on Monday to determine if he can play at the Oval and further delay an operation on his right knee.
Flintoff had been desperate to play a full part in the series, but skipper Andrew Strauss said he would not be selected at the Oval if medical opinion stated he would not be able to bowl for long periods.
Strauss also said that a decision would be taken early on Flintoff's availability.
"If he is going to play he has to be fit to play his role as an all-rounder. Maybe, he doesn't need to bowl 28 overs a day but he has got to be able to bowl more than one spell. We felt for this game he was unable to do that," The Telegraph quoted Strauss, as saying.
"He (Flintoff) was bitterly disappointed but obviously the decision was made having spoken to him about his level of fitness. He was very honest about how fit he was for this game. He is desperate to play in the final Test but he realises he has got to be fit enough to play and I am very hopeful he will be. From conversations we had with him we did not feel he was fit enough to play in the game [at Headingley]," Strauss added.
Flintoff is suffering from what is known as a chondral defect, which in essence means bone is rubbing on bone. The result is that the knee swells up, preventing smooth movement during a run-up to the bowling crease.
England certainly need Flintoff and not just for the balance he brings to the side. A bouncy Oval pitch suits his batting, he averages 53 there, and his presence would help motivate his best friend in cricket, Steve Harmison.