Ollie Robinson has been ruled out of the third and final Test against West Indies in Grenada, following a recurrence of the back problem that forced him to miss each of the drawn Tests in Antigua and Barbados this month.
The setback is a significant blow to a bowler who had been backed to lead England's attack in the Caribbean, following the omission of both of England's stalwarts, James Anderson and Stuart Broad. This was despite his fitness record being openly questioned by the team management after he suffered a similar back issue during the Hobart Test in January.
"Ollie wasn't as good as we would have liked or he was expecting himself," Joe Root, England's captain, explained on the eve of the Test. "It's just frustrating for him as it is for me. He's working very hard but there's something that's nagging away at him. I'm not sure exactly of the medical prognosis.
"He's just got to keep on doing what he's doing and trust in time that he's going to get himself back," Root added. "We all know how effective he has been and how good he's been in his short career up to now so the sooner we can get him back the better."
The setback caps an eventful first year as an England cricketer for Robinson - one which began with controversy during a seven-wicket Test debut against New Zealand at Lord's in June, when historic offensive tweets were made public on the first morning of the match.
He returned to the team after serving a suspension for that offence, and performed impressively against India, claiming 21 wickets at 21.33, including two five-wicket hauls. By the end of his maiden Ashes campaign, Robinson's record of 39 wickets at 21.28 confirmed the impression that he has the game to succeed in Test cricket.
However, his fitness was an ongoing concern during the Ashes. He rested for the Sydney Test, then broke down after just eight overs in the first innings of the fifth Test in Hobart, after which Jon Lewis, England's bowling coach, warned that his fitness levels were not up to scratch.
"If he's going to perform consistently over a long period of time at this level, he will need to be a fitter bowler, 100%," Lewis said at the time. "We've had those conversations, we've been pretty frank with him. And now it's up to him to go and do the work."
Now, however, after first suffering a recurrence of his back spasm during England's warm-up in Antigua, Robinson has been ruled out of each of the three Tests, and twice on the eve of the match after appearing to have done enough to be passed fit. England's other first-choice survivor from the Ashes, Mark Wood, was last week ruled out of the tour after suffering an elbow injury during the first Test.
In Robinson's absence, Chris Woakes is set to be given a reprieve, despite claiming just two wickets at 86.00 in the first two Tests. Craig Overton, who fell ill on the eve of the Barbados Test, will be the solitary change to the XI, as he comes back in for Matt Fisher, the man who stepped in to make his debut last week.
Although Matt Parkinson, the legspinner, had been touted for a call-up given the moribund nature of the first two Test wickets, the expectation is of a surface that will aid the quicks.
With the series locked at 0-0, there's all to play for, with West Indies defending a proud record of having lost just one Test series at home to England since 1968.
"I really hope we can take another step forward as a team and get across the line because there's been a lot of good stuff," Root said. "We've played the majority of the cricket up until now and it would be a great way to end the tour.
"The most pleasing thing is every game we've not had that nightmare session that's cost us a Test. We've looked at each individual session and each hour and looked to win each and every one of them.
"It's not always gone exactly like that but I think that mentality is really serving us well up to now. As long as we can keep driving that I don't think it will be long until we find ourselves winning games again."
England: 1 Alex Lees, 2 Zak Crawley, 3 Joe Root (captain), 4 Dan Lawrence, 5 Ben Stokes, 6 Jonny Bairstow, 7 Ben Foakes (wk), 8 Chris Woakes, 9 Craig Overton, 10 Jack Leach, 11 Saqib Mahmood