But after a starring role Down Under with the Lions that saw him start the two Tests that the tourists won, the 25-year-old looked to have won his fitness battle.
However a problem with his knee cropped up in Tuesday's training and with fellow Lion Mako Vunipola also out injured and Joe Marler recovering from a concussion he sustained against the Pumas last weekend, Wasps' loosehead Matt Mullan has been drafted into the squad.
And Stuart Lancaster is confident that the former Worcester Warriors star will serve as a suitable replacement.
"Alex took part in Tuesday morning's forwards training session but suffered some discomfort to his knee," he said.
"He did not train on Tuesday afternoon and will not be available for selection for the weekend.
"It's disappointing for Alex having missed last year's Six Nations because of an injury to his other knee.
"With Mako also unavailable, it's a great opportunity for Joe Marler and Matt Mullan, who has been with us all week and is raring to go in the 23."