Jacques Kallis will lead South Africa in the absence of Graeme Smith © Getty Images

Graeme Smith will miss the three remaining matches of South Africa's one-day tour of England, and is unlikely to play again until the tour of Australia in December, after failing to recover from a tennis elbow problem that has troubled him since the start of the tour. Jacques Kallis will stand in as captain.

Smith saw a specialist in London on Thursday and received a cortisone injection but, according to South Africa's coach Mickey Arthur, there is no question of his fitness being risked, especially with his side already struggling at 2-0 down in the five-match series. "If he played another game, [the elbow] could tear properly and that would require surgery," said Arthur. "It's just not worthwhile."

"He probably shouldn't have played from the end of the Edgbaston Test," said Arthur, "but it's a testimony to the captain that we have - he took injections and a lot of anti-inflammatories, and got himself out there for the Oval Test and the first two one-dayers.

"We were hoping to pull up a bit of a buffer early on in the one-day series and leave him out towards the back end, but it's just got too bad. He pretty much can't grip the bat with his top hand, and it's best for us to get him home, rehab, and get him ready for what is a huge summer for us when we get over to Australia in December."

However, according to Shane Jabaar, South Africa's physiotherapist, there is no guarantee that Smith will be fit to face the Australians. "A tennis elbow is a chronic problem and one can't say how long the rehabilitation will take," Jabaar told Supercricket. "We want to avoid surgery but if rehabilitation does not work we'll have to think again. I've been treating him since the first tour match [in Taunton at the end of June] and he has been taking painkillers."

Smith was first diagnosed with the problem during his stint with the Rajasthan Royals in the IPL in April, but all of the attention was focussed on the hamstring tear that threatened to rule him out of the first Test at Lord's in July. "He had five weeks out of the game, which helped both injuries," said Jabaar, "but we weren't told how serious the tennis elbow was. During our first tour match at Taunton it flared up while he was batting in the nets, and our job has been to somehow keep him on the field for the rest of the tour."

Ironically, it was Smith's superhuman stint with the bat at Edgbaston that, in the words of Jabaar, effectively "drilled a nail right through his elbow". By batting for five hours and 41 minutes for his series-clinching 154 not out in the second innings of that match, Smith compounded the problem to a grave extent.

"We'd been giving him pain-killers and anti-inflammatories, as well as icing and acupuncture," said Jabaar, "but that innings, which was far longer than we expected, effectively nailed him." In the circumstances, it is no surprise that Smith declared that Edgbaston innings to be the finest of his career, but it could have come at a price.

Kallis steps into the breach as captain, even though he resigned from the vice-captaincy last year after being omitted from the ICC World Twenty20 squad. "I took a day to consider, but my stand a year ago was about people getting involved in selection who shouldn't have been," said Kallis. "Back home that's now been sorted out, and at the end of the day it's something I'm very proud to be able to do."

Kallis's first role will be to galvanise his team's morale after they were rolled over for 83 in the second ODI at Trent Bridge on Tuesday but he was adamant that the task that faces him is not insurmountable. "Being booed off the field is more than enough motivation for the guys to put in a big performance," he said. "My message to the guys is to go out there and play their cricket. We fully believe we can turn this situation around."