Gambhir advised four-six weeks' rest

Gautam Gambhir could miss the limited-overs leg of India's tour of the West Indies next month following the aggravation of a shoulder injury that was sustained during the World Cup final. Gambhir, named India's captain for that part of the tour, has been advised four to six weeks' rest by Andrew Leipus, the Kolkata Knight Riders trainer, and could even miss the subsequent tour of England.

If it comes to pass, Gambhir's absence will leave India without their three best specialist openers - Virender Sehwag has recently undergone shoulder surgery and Sachin Tendulkar has been rested for the short-format games. It will also fuel the debate over the importance given to the IPL vis-a-vis international cricket, and - given that Sehwag also played through the IPL with his injury - raise questions over the responsibility of the BCCI, the IPL franchises and the players.

Gambhir played the IPL Eliminator on Wednesday, the same day Leipus wrote to the BCCI. However, Kolkata's loss to Mumbai Indians has saved Gambhir and the franchise from having to decide on his further participation in the tournament.

In his letter, addressed to BCCI secretary N Srinivasan, Leipus - a former India physio - said the player felt acute pain in his right shoulder while landing on it in the field at one point during the World Cup final against Sri Lanka at the Wankhede stadium on April 2. Subsequent scans have now revealed a serious injury that would require him to avoid throwing or batting for four to six weeks.

"Gautam arrived in Kolkata at the start of the IPL complaining of a 'sore shoulder', the onset of which occurred during the World Cup final," Leipus' letter said. "He clearly recollects a fielding incident where he landed on an outstretched arm and felt a catch deep in the shoulder. In the euphoria at the time, his attention was deservedly elsewhere and he didn't bother telling anyone about it."

Gambhir, he said, informed him of the shoulder pain when he arrived to play the IPL. "His initial complaints were pain in the shoulder and significant reduction of power in his throw. The clinical findings supported the mechanism of the onset of the acute injury, however, he did report having corticosteroid injections on two occasions over the previous few years," Leipus stated in his report, a copy of which is available with ESPNcricinfo. "Knowledge of this history leads me to suspect that any internal derangement may have been pre-existing and this recent incident (World Cup final) only served to aggravate or progress the injury (i.e. acute on chronic)," Leipus wrote.

Accordingly, Leipus said, he initiated a plan for management and rehabilitation, post which Gambhir only reported pain "intermittently". But during Kolkata's final group match at Eden Gardens on May 22, against Mumbai Indians, Gambhir winced in pain immediately after sending back a throw to the wicketkeeper from the deep. Leipus confirmed that the throw had "aggravated" the pain. The team then travelled for the Eliminator to Mumbai, where Gambhir consulted a prominent Mumbai-based surgeon and had an MRI scan taken.

"Both the doctor and myself believe that he should follow an intensive, supervised and conservative rehabilitation pathway. But for the best outcome, he will need to avoid both throwing and batting for a period of 4-6 weeks. In this regard I would expect that the BCCI medical committee would need to consider the ongoing management of Gautam's shoulder injury beyond the IPL and the possibility of his missing any immediate future tours until the shoulder is fully rehabilitated," Leipus said.

If Gambhir does indeed sit out that tour, Suresh Raina, appointed vice-captain, is likely to take over the leadership role.