KANSAS CITY, Mo. (AP) — In what Kansas City manager Matt Quatraro called “a no-brainer,” the Royals pulled left-hander Cole Ragans after three scoreless innings in his start against Cleveland on Wednesday night because of left triceps and elbow soreness.

“It’s routine for (pitching coach) Brian (Sweeney) to talk to the pitchers between every inning,” Quatraro said. “If somebody brings something up like that, it’s a no brainer.”

Luinder Avila started warming up in the bottom of the third and entered to start the fourth. Avila (0-2) took the loss in a 3-1 decision that snapped the Royals’ five-game winning streak.

Ragans, 28, allowed one hit, walked two and struck out four, throwing 58 pitches. He is 1-4 with a 4.84 ERA. this season.

He said he started feeling the discomfort during the third inning.

“It just started to get a little tight,” Ragans said. “I talked to Sweeney, and figured that was the best decision.”

Ragans had Tommy John surgery in March 2018 while in the Texas minor league system, then tore the grafted ligament during his rehabilitation and had a second Tommy John surgery in May 2019. He returned to the major leagues in August 2022.

He said this discomfort was nothing like what he experienced previously.

“I know what I’ve been through, the elbow stuff. I know it’s not what I’ve been through before,” he said.

He was traded to Kansas City in August 2023 and became a first-time All-Star in 2024, going 11-9 with a 3.14 ERA in 32 starts. He was sidelined between June 5 and Sept. 17 last year because of a strained left rotator cuff.

He walked two batters in the first inning and escaped the two-on, one-out trouble by striking out Rhys Hoskins and David Fry.

Quatraro seemed optimistic that the injury was not serious.

“He just started having some tightness (or) soreness in the back of the elbow/triceps area,” he said. “So (we were) just trying to be cautious and get him out of there.

“We’ll get some more evaluations tomorrow and see what we have. We don’t think it’s serious. We’re hopeful for the next start, and we’ll just see where he is after we evaluate it tomorrow.”

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