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Orioles keep winning, but concerns about pitching health persist

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Last month’s trip to St. Louis not only marked the first time the Orioles were swept in the regular season in two years, but it brought the loss of two-fifths of their starting rotation.

We’d soon learn after that three-game series that lefty John Means would need Tommy John revision surgery on his left elbow and right-hander Dean Kremer would go on the 15-day injured list with a right triceps strain. The good news is Kremer has thrown a few bullpen sessions and is expected to go on a minor-league rehab assignment in the near future, but neither Means nor right-hander Tyler Wells — who had been out since mid-April — will pitch again in 2024.

Despite those recent challenges, Baltimore has gone 15-4 since losing three straight to the Cardinals and entered Wednesday ranking third in the majors in runs allowed per game (3.52). The makeup of the rotation and bullpen continues to change, and the Orioles are still making it work.

But how much is too much?

The latest blow is “left elbow inflammation” landing reliable southpaw reliever Danny Coulombe on the IL. Manager Brandon Hyde told reporters on Tuesday that Coulombe was still undergoing tests and the Orioles were “hoping for the best there.” Interpreting injury-related comments is largely an effort in vain, mind you, but that assessment didn’t sound as encouraging as an IL move strictly being a “precautionary” decision. It’s worth noting that Coulombe went to the IL for 15 days last August with left biceps tendinitis, but elbow and shoulder problems sound louder alarms for pitchers.

In 26 innings this season, Coulombe has posted a 2.42 ERA and struck out 9.7 batters per nine frames. He threw a season-high 30 pitches over two scoreless frames against Tampa Bay in his most recent appearance on Saturday, but that came three days after he had last pitched in Toronto.

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Acquired from Minnesota for cash consideration a few days before the start of the 2023 season, the 34-year-old Coulombe has been nothing short of outstanding in a total of 90 appearances covering 77 1/3 innings, pitching to a 2.68 ERA and averaging 10.0 strikeouts per nine innings since the start of last season. Coulombe has been as effective against right-handed batters as lefties, which has given Hyde the confidence to use him in a variety of spots. He’s even recorded the only three saves of his career since arriving in Baltimore.

You’ll recall that Coulombe was the one to relieve All-Star closer Felix Bautista after the big right-hander injured his elbow against Colorado last August 25. Even in that moment of devastation that resulted in Bautista needing Tommy John surgery, Coulombe signaled that the Orioles would be OK, and the bullpen held it together the rest of the way to win 101 games and the AL East division title.

A year later, the bullpen continues to be a hot topic of conversation with both media and fans clamoring for general manager Mike Elias to add another impact arm or two before the trade deadline. And while the Orioles entered Wednesday ranking fourth in the majors in bullpen ERA and seventh in bullpen wins above replacement, that angst will only grow even if tests reveal a more favorable outcome on the health of Coulombe’s elbow. But even if only temporary, losing someone who’s been no worse than your third-best reliever since the start of last year is a difficult pill to swallow, especially with series against baseball’s top two teams — Philadelphia and the New York Yankees — looming.

The Orioles keep winning, but the pitching health concerns won’t quit.

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