By Tom Fordyce

Are England in danger of blunting their talisman?

Just before the first Test against the West Indies, the chief medical officer of the England and Wales Cricket Board, Peter Gregory, stated that Andrew Flintoff was not fit to bowl because of a bone spur on his left ankle.

KNOW YOUR BONE SPURS Spur is extra bit of new bone formation Flintoff's probably caused by biomechanics of his bowling action Twice his bodyweight passes through his left ankle on delivery Achilles tendon under immense strain trying to decellerate foot as it slams into ground Traction on Achilles leads to growth of extra bone in heel as body tries to protect itself Soft tissues between bone and the spur get trapped and become painful and inflamed Cortisone injection reduces inflammation and pain Injection manages symptons but does not solve cause Operation to trim spur simple but recovery time 12-16 weeks Academy: Read more about cricketing ankle injuries

On Friday afternoon, he had changed his view.

"Provided he remains pain-free, he will be able to bowl," Gregory announced.

Flintoff duly grabbed the match by the scruff of the neck, taking three wickets in 12 balls on Saturday before belting the West Indian attack to all corners the following day.

So far, so good - or perhaps not.

Flintoff was able to bowl pain-free because he had been given a cortisone injection, which reduced the inflammation in his ankle.

These are the very injections which Gregory previously described as "not without risk".

The injury itself - a result of Flintoff's bowling action, which sees him stamp down his left foot with immense force - remains.

So are England risking the long-term health of their most inspirational player for short-term gain?

Should Flintoff have an operation to deal with the bone spur now, or can he continue to thrive as a Test match fast bowler regardless?

David Lloyd, who formerly coached Flintoff at Lancashire, cannot believe how his former charge is being handled.

"England have done him no favours at all," he said.

"If anything happens to Freddie because of this policy, I won't be the only one who's angry."

No pain, all gain

Flintoff himself is bullish.

"I had the injection on Monday, and I responded well to it. I felt no pain after a couple of days. If I had any pain I wouldn't have bowled," he said.

"To be honest, an operation has never been mentioned. The specialist says if we can get rid of the inflammation, the chances are it will be fine.

"The spur isn't big enough (to operate on). I don't feel as if I'm injured, to be honest."

But that's part of the problem. A cortisone injection ensures that Flintoff wouldn't feel any pain, so his discomfort-free bowling performance on Saturday is not an indication that all is suddenly well.

Flintoff too, like any competitive sportsman, wants to be involved.

He is an uncomplaining character, who is happy to do the tough yards for Michael Vaughan whenever the captain needs him.

As such, he might not be the best person to decide on his own treatment.

Australia's Glenn McGrath suffered an almost identical injury 18 months ago, and kept bowling in the belief that, because the spur on his ankle was small, it could be contained.

It couldn't. McGrath has only just returned after a year out that threatened at one stage to be the end of his career.

There is another precedent for Flintoff. Two years ago he played through the summer series against India with a hernia, failed to recover and ended up missing the entire Ashes series that winter.

England play Australia again next summer. To have a chance, they need Flintoff to be fit and at his most inspirational.

The question for the England management is simple: is it worth Flintoff risking missing this winter's series in South Africa and the Ashes that follow in order to rattle out a few West Indian batsman this summer?

Worn out by workload

Jacques Kallis, the world's leading all-rounder, is convinced that Flintoff's workload with ball and bat could shorten his career.

"It's hard work doing both, especially with the amount of cricket being played these days," he said.

"It's tough. All-rounders will diminish if we don't cut back."

Taking the long-term view while immersed in the immediacy of a tight battle is never easy.

If Flintoff is telling Vaughan that he feels fine, and the England medics are also giving him the green light, it is hard not to throw him the ball when England need a breakthrough.

But injuries and pain are the body's way of saying that something is wrong. If Flintoff continues to bowl, the bone spur will not disappear.

Pay now or pay later? England must decide.