Charlotte Bobcats center Al Jefferson was forced out of Monday night's Game 4 playoff game against the Miami Heat because of a foot injury.
Jefferson did not take part in the team's shootaround Monday.
"He's not close to where he was for the last two games," coach Steve Clifford said.
Jefferson, who led the team with 21.8 points and 10.8 rebounds per game during the regular season, strained the plantar fascia in his left foot in the first quarter of Game 1.
Clifford said Jefferson's condition worsened in Game 3 and having just one day off did not help his chances of playing Monday night.
Jefferson said he feels like he is "walking on needles."
"I wouldn't wish this pain on anyone," he said. "It's the worst pain I've ever dealt with in my career."
Bismack Biyombo was expected to start in place of Jefferson. Biyombo has never scored more than 14 points in a game. He has played only 15 minutes in the series and scored one point.
Miami leads the best-of-seven series 3-0.