Less than a week after his long-awaited international comeback, Andrew Flintoff is facing the possibility of missing another England match because of injury. Although he is keen to play today against India in the third match of the NatWest Series at Edgbaston, the final say on a sore right knee will not be his alone.

Flintoff was given a cortisone injection on Saturday after a scan showed mild swelling and he did not bowl in the nets yesterday. Peter Moores, the head coach, said that the all-rounder is highly unlikely to play as a specialist batsman, as he has done during previous periods of injury with some success.

This suggests that England are now, at last, prepared to pay more than lip service to the stated intention of taking a long-term view of Flintoff’s health. Even so, it must be a concern that he has had a second injection since saying in Australia last winter that he felt uncomfortable about the thought of more jabs.

Moores is soon to discover, like Duncan Fletcher before him, that talking about the long term is not so straightforward when the player is needed to balance the side in the present. “The days when you just used to stick jabs in people are gone,” Moores said, by way of defence. “I think they take a far more long-term view now.”

Flintoff bowled at up to 93mph in the first one-day international at the Rose Bowl, where he first felt pain in the knee, and then returned career-best figures of five for 56 in the second match, in Bristol. Moores attributed the problem to an increase in intensity after his return in county cricket. “Maybe his body is getting used to that intensity again,” Moores said.

That Jon Lewis has been drafted into the squad suggests that England value the bowling side of Flintoff more highly. If he is absent, then Ravi Bopara and Dimitri Mascarenhas could climb a place each to six and seven, allowing Monty Panesar to return, with Lewis and Chris Tremlett contesting the final seam position.

Alternatively, the introduction of Owais Shah would stiffen the batting, but leave Bopara and Paul Collingwood to share ten overs against batsmen who scored 329 last Friday, admittedly on a ground with club-sized boundaries. An attack without Flintoff leaves a huge onus on James Anderson to provide a cutting edge.

“We will see where we are in the morning,” Moores said, confirming that Flintoff has at least suffered no recurrence of trouble in the left ankle. “It is only right to give him the extra time. He is keen to play, as he would be having been out for so long, but we have to make sure we balance things over a long series.

“It would be difficult to tell him he is not playing if he wants to, but these things tend to work themselves out. He knows there is a lot of cricket to come. You look to the player to a degree, but you also talk to others for their expertise. Between Fred, myself and the medical team, we will make the right decision.”

In this series, the longest between two teams to be played here, there are four more matches after today. England then fly straight to South Africa for the ICC World Twenty20 – a tournament in which Flintoff is keen to participate – and follow that with five one-day matches in Sri Lanka. All this before Test commitments.

Whatever fate befalls Flintoff this morning, Panesar seems certain to return. However, the start at 10.15 – brought forward to allow extra time if needed at the end – is ideal for seam. “Historically, it has been challenging to bat so early when it is overcast,” Moores said. “If the weather is fine, it may not make much difference.”

India hope that Zaheer Khan will return after flu, but it will not be at the expense of either Piyush Chawla or Ramesh Powar, the spin bowlers, who took four key wickets in Bristol. Sachin Tendulkar, who felt too weak to field after scoring 99, played a full part in practice yesterday.

Edgbaston squads

England (from): P D Collingwood (capt), J M Anderson, I R Bell, R S Bopara, S C J Broad, A N Cook, A Flintoff, J Lewis, A D Mascarenhas, M S Panesar, K P Pietersen, M J Prior, O A Shah, C T Tremlett. India (from): R Dravid (capt), A B Agarkar, M S Dhoni, G Gambhir, S C Ganguly, K D Karthik, M M Patel, Piyush Chawla, R R Powar, R P Sharma, R P Singh, S R Tendulkar, R V Uthappa, Yuvraj Singh, Zaheer Khan. Umpires: B R Doctrove (WI) and M R Benson