CHICAGO — John Means is headed back to the injured list, continuing a series of setbacks that have marred the better part of the last two years.

The Orioles placed the left-handed starting pitcher on the 15-day injured list Thursday with a left forearm strain, one day after his start against the St. Louis Cardinals was cut short because of elbow discomfort. On Thursday, manager Brandon Hyde said Means is still set to undergo testing to determine the severity, but any elbow discomfort for Means is worrisome, given his history.

“We’re hoping for the best,” Hyde said. “It’s disappointing because he’s worked so hard to get back, was a huge boost for us in September last year after the long road back, and was throwing the ball well. Could tell something was a little bit off yesterday, but hopefully we get good news today.”

To replace Means, the Orioles called up right-hander Jonathan Heasley.

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Means underwent Tommy John elbow reconstruction surgery in 2022 and missed the rest of the season. A back strain during his recovery set his return back further, but Means stepped on the mound again late in 2023. However, before an expected start in the postseason, Means suffered elbow soreness and was left off the American League Division Series roster.

The Orioles slow-played Means’ buildup this winter, hoping extra rest would allow his elbow to fully heal. Once Means returned this month, he pitched well. But on Wednesday Means’ velocity was down and Hyde said the pitcher’s appearance would have ended after three innings even before a rain delay swept in.

From 2022 to 2024, Means has thrown 52 1/3 innings.

The velocity decline Means exhibited in St. Louis was the first indication something was amiss. His fastball averaged 88.9 mph, about 2 mph slower than usual. He shook out his arm, and the MASN broadcast showed Means heading into the dugout between innings with pitching coach Drew French.

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“For us, it was the first time it was noticeable, where the velocity was down a little bit,” Hyde said. “He felt he could still push through, still wanted to pitch, but that was really the first time it was noticeable.”

With Means’ injury, Baltimore’s plans for a six-man rotation during a gauntlet of games in June might fall by the wayside, although Hyde didn’t rule it out.

“It’s so hard to plan too far ahead,” Hyde said. “That’s why I’m always a little wishy-washy on my answers on when we’re going to do certain things, because things like this come up and they seem to happen. You kind of just roll with it.”

Left-hander Cole Irvin, who pitched out of the bullpen recently, will likely take Means’ rotation spot. And Heasley, who owns a 0.45 ERA in 20 innings for Triple-A Norfolk, could take the long relief role. He pitched five innings in his last outing.

“Been throwing the ball well down there,” Heasley said. “Felt like I got into a good little rhythm, cleaned up some things I felt I needed to. Just some small, mechanical things.”

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The Orioles floated a six-man rotation because of the glut of starters at their disposal, as well as a stretch that features 30 games in 31 days. Without Means for the time being, Baltimore still has a strong five-man rotation: Corbin Burnes, Kyle Bradish, Dean Kremer, Grayson Rodriguez and Irvin. Right-hander Tyler Wells, recovering from his own elbow predicament in Florida, may eventually be an option as well.

The Orioles also have minor league starting depth with Cade Povich and Chayce McDermott. Povich holds a 2.08 ERA and McDermott’s ERA is 3.77, and they have two of the best strikeout rates in Triple-A.

“You can’t have enough starters; you can’t have enough pitching,” Hyde said. “We still have a long way to go and a lot of things can happen, so we’ll be relying on our depth, we’ll be relying on guys in Triple-A, and we feel good about the roster we have.”

Baltimore Banner reporter Danielle Allentuck contributed to this report.