Stokes played the Third Test against West Indies as a batsman due to the injury, meaning No3 Zak Crawley was left out. Stokes had a fitness test this morning, bowling a few deliveries, but it was decided that he should not be risked in his full role, so England stuck with the same four-man seam attack that was so effective in the Third Test against West Indies: James Anderson, Stuart Broad, Chris Woakes and Jofra Archer.
Captain Joe Root said: "He's just not quite 100 per cent fit and we feel it's too big a risk, given it's the start of the series and the amount of cricket that's left this summer. His runs have been invaluable and he's a huge part of our dressing room, so we didn't want to take that risk."
That seam attack was straight into action, as Pakistan captain Azhar Ali won the toss and opted to bat first. That is in part because his side includes two leg-spinners, Yasir Shah and Shadab Khan (who will bat at No7), alongside the exciting seam trio of Mohammad Abbas, Shaheen Shah Afridi and Naseem Shah. The latter pair are aged 20 and 17 respectively.
It could be argued that the captains made the wrong decision at all three tosses in the series against West Indies, with Stokes opting to bat when England were bowled out for 204 at the Ageas Bowl, then Jason Holder twice choosing to bowl at Old Trafford and watching the hosts rack up game-shaping first-innings scores 469 of and 369.
This was another awkward decision at the toss, with the pitch looking good for batting but thick cloud overhead and the floodlights on. Root said that he would have batted, but privately he and his batsmen might well have been relieved to lose it.
England have lost eight of their last 10 series openers, including the last five, and Azhar's decision at the toss gave the hosts a great chance to get a better start to what will be an extremely tough series. England have not won a Test series against Pakistan since 2010, and Pakistan earned draws in this country in 2018 (1-1) and 2016 (2-2).
English cricket loves a long-term, detailed plan. It took the Test team to No1 in the world with wins in Australia and India at the start of the last decade and Eoin Morgan's ODI side to World Cup glory last year.
Root and head coach Chris Silverwood now have a clear vision of how they want the Test team to play, with the express aim of winning the Ashes in Australia. It informs many of the big decisions they make, including the dropping of Stuart Broad for the first Test of the summer against West Indies.
England — and, indeed, Australia — can become rather too preoccupied with the Ashes. It is the most commercially powerful series either side plays, by some distance, with the bragging rights on offer far exceeding any other series, and players' careers often defined by their deeds in those matches.
Much of the work England are doing with the Ashes in mind is positive, but they must not forget the major challenges that lie right before them.
Before they go to Australia, they have two tours of the subcontinent (against Sri Lanka and India), as well as a series against India, who have been the world's best Test team in recent years, at home. Then there is this contest, which will prove a step up from the series against West Indies, which they won 2-1.
In Babar Azam, Pakistan possess one of the world's best batsmen, and their varied attack — which includes right-arm seam in Abbas and pace in Naseem, as well as left-arm pace in Shaheen and the two leggies. England's top order made progress against a decent West Indies attack, but this will be another challenge altogether.
"Pakistan generally have lots of different angles that they attack you with, they've got a rich history of fast bowling," said Jos Buttler this morning. "Leg-spin as well, so a few different challenges to the West Indies."