 Flintoff has had three operations on his problematic left ankle |
Flintoff, 29, has been repeatedly troubled by his left ankle, casting doubt over his long-term future.
"They have to make a decision now," Gatting told BBC Radio 5live.
"They've either got to say, 'Right, you have got to bowl through it', or they give him six months off, or at least five before the Tests in New Zealand."
England are scheduled to play five one-day internationals in Sri Lanka in early October before returning home. They then return to Sri Lanka in late November for a three-Test series.
After another break England land in New Zealand on 28 January and play a series of warm-up fixtures and one-day internationals before the first of a three-Test series starts in Hamilton on 5 March.
Flintoff had a third operation on his troublesome ankle in June and there have been concerns over his long-term future, especially at Test level.
Gatting added that if England give Flintoff a long rest he must use the time to strengthen the problem area.
"Just say, 'Rest it, give it a chance to get stronger, work on it and let's really give it a chance to heal'," he said.
Australia skipper Ricky Ponting said after his team's defeat of England at the Twenty20 World Cup that Flintoff should be given a lengthy spell out of the game to fully recover.
Ponting said: "I've been a bit surprised that he seems to have been rushed back into the team a lot during the past couple of years.
"He looks like he's aggravated the ankle again fairly early, which probably indicates that he hasn't been ready to go again.
"Maybe it's got to the stage where the England management need to give him six months away from the game to get his ankle looked after and get back his fitness. He might just need some really good rehab time.
"He's such a big player for England. They need him fit and firing. He's 29, so there's a lot of cricket left for him if he can get his body right."
Bollywood
Tum Se Tum Tak
Fan Fictions
681