Luther Burrell is unlikely to feature in England's first autumn Test against New Zealand at Twickenham on 8 November, says coach Stuart Lancaster.
"It will be tight for New Zealand given he has not been in camp this week," Lancaster said.
The news is a further blow to England's midfield options, with Manu Tuilagi already ruled out.
Lancaster said Saracens centre Brad Barritt would "clearly be someone we'd consider" to play outside-centre against the world champions.
He could form a new-look partnership with Bath centre Kyle Eastmond, whom Lancaster is confident will recover from a rib injury in time to train next week.
Billy Twelvetrees and Jonathan Joseph are the other centres available if Burrell is not fit.
Lancaster says Burrell's injury is not as severe as first thought and he "could come into the equation" for the later autumn Tests against South Africa, Samoa and Australia.
Burrell featured in two of England's three Tests against the All Blacks in New Zealand this summer, having been England's first-choice number 13 throughout the Six Nations earlier in the year.
Joe Marler, Billy Vunipola, James Haskell and Marland Yarde are recovering from illness or light injury, but Lancaster is confident they will be able to resume full training next week.