Official site of the England and Wales Cricket Board
Chairman of selectors David Graveney believes England will lose the symbol of their side should Ashley Giles be ruled out of the tour of India.
England face an anxious wait on their number one spinner's availability for the nine-week trek which begins on February 12.
Giles, 32, is behind schedule in his rehabilitation following hip surgery last month and was referred back to a specialist by the England and Wales Cricket Board.
The ECB's chief medical officer Dr Peter Gregory will now assess the findings of Giles' medical update in the next couple of days before advising on his participation or otherwise.
"If he cannot tour it would be a big loss to us," said Graveney. "But that is sport.
"If you had to pick one person to epitomise the spirit of the team it would be Ashley. His role, both within the side and the dressing room, should not be under-estimated."
The Warwickshire star has been an integral member of Michael Vaughan's successful side, especially during last summer's Ashes.
"His figures may not always look as good as some of the other spinners around the world but he fulfils a crucial role in our attack," insisted Graveney.
"And it is not only his work with the ball: there are the catches he takes in the gully and the vital runs he scores at number eight."
Giles played through the discomfort his hip was causing in the opening matches in Pakistan but finally succumbed prior to the third Test and opted for surgery in London on December 7, a date it was hoped would allow enough recovery time ahead of the Indian leg of the winter.
Captain Vaughan and fast bowler Simon Jones are also recovering from operations in England's quest to be at full strength against India, with the sides playing for second place in the ICC Test rankings.
But Giles has not made the progress he might have hoped for when he underwent the knife seven weeks ago; although he has begun a relatively intense fitness programme, he did not turn his arm over as planned last week.
"There has been a setback and Ashley has not been able to resume bowling," confirmed an ECB spokesman.
"He saw a specialist in London yesterday (Tuesday) and the findings of that meeting have been passed on to us.
"Peter Gregory now needs time to digest the findings of the report."
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Official site of the England and Wales Cricket Board