England captain Ben Stokes is out of the first Test against Pakistan, with Durham seamer Brydon Carse in to make his debut.
Stokes, 33, has not played since the beginning of August, but England said 10 days ago he was “on track” to participate in this tour.
The all-rounder mainly trained apart from the rest of the squad before batting in the nets in Multan on Saturday, then confirmed he would miss the Test starting on Monday.
Ollie Pope, who led England during the 2-1 series defeat of Sri Lanka, will continue to deputise as captain.
“I tried my hardest to get myself fit for this game, but have taken the call to miss this one because I’ve not quite managed to get game-ready,” Stokes told BBC Sport.
“There is a lot that has to go into my rehab programme. We got to a certain point, but looking at the picture of what we’ve got coming up and physically where I’m at, I’m not quite ready to play.
“It’s always frustrating to miss out. I’ve got some good things to focus on, so even though I’m not playing I’ve got a goal in mind.”
Stokes’ attention will now turn to the second Test, also in Multan. In a tight tour of three back-to-back Tests, that match begins in 10 days, on 15 October.
Asked if that is a realistic goal, Stokes said he is “not sure”.
“I’ve pushed myself incredibly hard and worked really hard with the medical team to get to where I’m at now. I think I’m further ahead than what we expected.
“I’ll be working just as hard over the next 10 days to try to get myself fit for the second Test.”
