Means leaves game with apparent injury (updated)

What began as a routine mound visit this afternoon from pitching coach Chris Holt in the first inning turned into a situation that's much more alarming to the Orioles.

Left-hander John Means might be hurt.

Means walked off the field with two outs, the Orioles behind 2-0 and Indians rookie Owen Miller coming to the plate.

Holt signaled for manager Brandon Hyde and head athletic trainer Brian Ebel. A brief exchange was followed by Means and Ebel walking to the clubhouse and former Indians pitcher Adam Plutko rushing to get ready.

Means threw 29 pitches, the first nine to leadoff hitter Cesar Hernandez, who homered on a 93 mph fastball. Amed Rosario grounded out and José Ramírez struck out on a 95 mph fastball - Means' velocity seemed fine - but Harold Ramírez drove a changeup over the center field fence.

Eddie Rosario singled on a curveball and Holt came out of the dugout.

Plutko retired Miller on a popup, but the greater concern was Means, the staff ace and possible All-Star who began the day with a 2.05 ERA and 0.796 WHIP in 11 starts over 70 1/3 innings.

The ERA ranked second in the American League behind the White Sox's Lance Lynn (1.23) and sixth in the majors heading into today's game. His WHIP was first in the American League and his .173 average against was third.

Means has surrendered 13 home runs, including two in each of his last four outings.

Hernandez hit his 17th career leadoff homer and fourth this season, the ball traveling 414 feet into the Orioles' bullpen. Harold Ramirez's ball carried 396 feet, according to Statcast.

Today tied the shortest start of Means' career. He lasted only two-thirds of an inning on Aug. 16, 2020 against the Nationals after being reinstated from the bereavement list.

Means, 28, threw a no-hitter on May 5 in Seattle and hadn't gone fewer than 4 2/3 innings before today.

Means didn't break camp with the Orioles last summer due to left arm fatigue. He's been their workhorse this season and the pitcher most likely to extend their winning streak to four games.

"When we have Means pitching, you can bank on it that Means is going to go five or six at least," Hyde said earlier today. "He's become so reliable in that way that, I don't want to jinx it, but you figure that he's going to go pretty deep in the game."

Update: The Orioles announced that Means left the game with left shoulder fatigue. More information will be provided later today.

Means was working on six days' rest and Hyde has been careful with innings and pitch counts since the no-hitter.