Chris Tremlett appears to be a serious doubt for the second Test, in which England are hoping to bounce back against Pakistan.
The fast bowler, who returned to the England attack in last week's first match of three, has again succumbed to soreness and stiffness in his back and side.
That same affliction kept him out of the England reckoning for five-and-a-half months, after a hamstring injury led to a back problem on the eve of last summer's Trent Bridge Test against India. Initial indications, as England began their practice session, were not encouraging either as Tremlett sat watching his team-mates go through training drills.
A few minutes earlier, captain Andrew Strauss said: "He had a sore back and side yesterday, and he's going to have to bowl today before we know whether he's fit or not.
"It's a little bit up in the air at the moment. We'll obviously know more after practice today."
England have not sent Tremlett for a scan, however.
"No, it's not one of those ones," added Strauss.
"But there's some general stiffness and soreness, so it's a case of whether that loosens up or continues.
"We'll probably only know that after practice."