His decision to concentrate on getting fit for Lancashire came during the second day's play at the Premadasa Stadium, where Pakistan made a respectable 200 for two in reply to Sri Lanka's 330 in the first innings.
Akram said: ``It may take a few weeks before I shall be able to bowl. I can't move my bowling arm and I need proper therapy.''
Waqar Younis, Akram's Test bowling partner who has broken a bone in his left foot, has also dropped out of the tour. He joins Glamorgan shortly.
The replacements for the pair are the medium-paced Abdul Razzaq and the left-arm spinner Mohammad Hussain, who are due to arrive shortly.
Meanwhile, Pakistan salvaged the situation with two valuable partnerships, beginning when Ramiz Raja added 102 with Ijaz Ahmed for the second wicket.
Ijaz, who was 90 not out at the close, then shared a 98-run unbroken stand for the third wicket with Salim Malik.