Reigning MVP Giannis Antetokounmpo is out for Game 5 of the Milwaukee Bucks-Miami Heat series on Tuesday night, the team announced. The Bucks superstar re-injured the same right ankle in Game 4 that he twisted in Game 3 and did not return. However, Milwaukee kept its season alive after pulling out a 118-115 overtime win in Game 4 on Sunday, despite playing the final three quarters and overtime without Antetokounmpo. The Bucks, though, are down 3-1 in the series, and face elimination again Tuesday night. Without Giannis in the lineup, Milwaukee will rely heavily on Khris Middleton and Eric Bledsoe to try and fight for another win against the Heat.

When Antetokounmpo arrived to the arena ahead of the Bucks warmup for Tuesday night’s game, he was wearing a boot on his right foot, but didn’t have too much of a limp when he walked. He was getting shots up during pre-game, but clearly Milwaukee felt it wasn’t worth the risk to their franchise star.

Antetokounmpo sprained his ankle while drawing a foul on a drive early in the second quarter of Game 4. He let out an audible scream and stayed on the floor for a couple of minutes before being helped to the bench.

He was able to shoot his free throws, which would have allowed him to return, but the Bucks ruled their superstar out for the rest of the game just after the halftime whistle. He finished with 19 points and four rebounds in 11 minutes — and finished with more points than Jimmy Butler despite playing 27 fewer minutes.

Nothing has gone right for the top-seeded Bucks in this series, and losing Antetokounmpo for Game 5 is a huge blow for a team that had its sights set on the NBA Finals. Middleton will be asked to turn in a similar performance to his 36-point outing in Game 4, to give Milwaukee any chance of staying alive in this series.