ST. LOUIS — John Means left Wednesday’s game after three innings with elbow discomfort, a worrying sign that comes two years after Means had Tommy John reconstructive elbow surgery and seven months after he experienced elbow soreness that took him out of the playoffs.

Means’ velocity was down Wednesday. He averaged 88.9 mph on his fastball, compared to his typical 90.9. Means tried to shake his arm out between pitches, and the Orioles were intending to end his start after the third inning regardless of a rain delay that stopped the game for 1 hour and 25 minutes.

He is having testing done. The team does not know the severity of the injury.

“That was disappointing,” manager Brandon Hyde said. “I could tell something wasn’t right and that he was trying to gut through it. But he did feel some elbow soreness. We are hoping for the best.”

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Means — the Orioles’ strongest starter from 2019 to 2021 — hurt his elbow in April 2022, getting Tommy John surgery shortly after. He experienced a back strain during his recovery, setting back his comeback a few months. He returned in September 2023, just as the Orioles were gearing up to clinch their first playoff spot since 2016. He made four starts, pitching to a 2.66 ERA.

Means was expected to start a playoff game, but he experienced elbow soreness and was not available for the American League Division Series. That soreness pushed back his offseason timeline, and he entered spring training a month behind the other starters, thus pushing the start of his season back a month.

He made his first start May 4, pitching seven shutout innings against the Reds. He allowed four runs in 4 2/3 innings in his next start against the Diamondbacks, then two runs in six innings against the Mariners.

On Wednesday, he fared well despite the discomfort, allowing one hit and no runs in three innings.

If Means’ injury leads to a trip to the injured list, the Orioles could turn to Cole Irvin to fill his spot in the rotation. Irvin was moved to the bullpen when Grayson Rodriguez returned from the injured list last week but pitched to a 2.90 ERA in his seven prior starts, giving up just two runs over his last four.