Matthew Hayden has warned Kevin Pietersen that his comeback from an Achilles injury could be the toughest battle of his career, after it was confirmed the England batsman was admitted to a central London hospital for treatment on an infection in the stitching of his surgically-repaired right ankle.
Pietersen, who underwent the operation two-and-a-half weeks ago after England's victory in the second Test at Lord's, is expected to be discharged on Wednesday after spending two nights in hospital. He has been placed on a course of antibiotics and will be reassessed later in the week before resuming his rehabilitation programme, but Hayden, who also sustained a high-profile Achilles problem during the first season of IPL, said that it was a problem that was unlikely to go away.
Hayden's own Achilles problem did not require surgery, but it nevertheless curtailed his international career. He missed Australia's 2008 tour of the Caribbean and averaged just 23.93 in nine Tests thereafter. Despite harbouring ambitions to play through to the end of the current Ashes series, Hayden announced his retirement from international cricket in January.
"Frankly, the hardest thing I ever had to do was come back from that," Hayden told Cricinfo's Switch-Hit podcast. "My path was one of very gradual improvement over a long period of time. That was under very strict guidelines and rehabilitation programmes, and it's to a point now thankfully, touch wood, it's brilliant, but it's [an issue] of constant maintenance. What I do know about any kind of tendinopathies, having suffered them right the way through my career, is that they are often a degenerative injury.
"It's not like a hamstring where you go out and pull it, and you spend a number of weeks getting back in through rehab. These are degenerative tendons, so ever since Kevin Pietersen has been running around on the plains of Africa, he would have been wearing out his Achilles tendon. Being such a big bloke, as is often the case with very long levers, it tends to increase the degree of injury. He's good a long road to go, there's no question about that."
Pietersen's setback in his road to recovery was confirmed on Tuesday afternoon in a statement from the ECB. "He was seen by a wound care specialist yesterday and will receive a course of anti-biotics in order to exclude infection," read the statement.
"Medical advice is that a complication can occur post surgery and in this case resulted despite Kevin closely following specialist advice on management of the wound. He will be reassessed by the specialist later this week and will return to his planned programme of rehabilitation once the wound has fully healed."
Pietersen's operation was conducted by a leading Swedish specialist, who was flown in at the ECB's behest, and an initial estimate was that he would be out of cricket for six weeks.
That may now have to be revised. The operation, which Pietersen underwent after labouring to twin scores of 32 and 44 in the Lord's Test, involved a small incision and trimming of the blood vessels and nerves around the inflamed tendon and was considered, in a statement from Nick Peirce, the ECB's chief medical officer, to have been routine.
"Kevin will look to undertake a comprehensive rehabilitation programme to ensure there is no risk of recurrence," said Peirce at the time. "This is expected to be approximately six weeks but will be taken at an appropriate pace following constant review."
Pietersen was never in contention to be fit for the remainder of the Australia tour, and his initial target was the tour of South Africa which gets underway with the Champions Trophy on September 22.
However, England's national selector, Geoff Miller, admitted to Cricinfo that there were already concerns about his longterm fitness. "I'm hopeful he will be fit [for South Africa]," said Miller. "I wouldn't say I'm confident, but I'm very, very hopeful, because he's an integral part of the side."
In Pietersen's absence, England's middle order has struggled to match his authoritative style of batting, and at Headingley this week, Nos 3, 4 and 5 - Ravi Bopara, Ian Bell and Paul Collingwood - mustered 16 runs for six dismissals, the lowest combined tally in Test history.
"I hate missing matches for England and especially during an Ashes summer but now that the decision has been made to undergo surgery I'm confident I can return to the England team injury-free following a course of rehabilitation," said Pietersen at the time of his injury.