Zach Britton remembers the time he started to put shoulder issues in the past

Recently we have been hearing much about platelet-rich plasma (PRP) injections for pitchers in professional baseball. In recent weeks, Orioles minor league pitchers Hunter Harvey and Branden Kline had PRP injections.

PRP is blood plasma that has been enriched with platelets and stimulates the healing of bone and soft tissue. A pitcher that gets such an injection usually must rest for about six weeks.

Long before Harvey and Kline had PRP injections - and they are much more prevalent now - Orioles closer Zach Britton had one in March of 2012 in his inflammed left shoulder, which started to bother him late during the previous season.

This was no quick fix or cure-all for Britton, but the PRP injection would eventually lead him to health and provide him a framework and education to keep that shoulder healthy. He is now one of the best closers in the American League and yesterday got his 14th save in 15 chances in 2015. He has a 2.05 ERA, a .226 batting average against and 28 strikeouts, with just three walks in 22 innings.

Britton never needed shoulder surgery - he had inflammation, nothing more serious - and said the PRP injection eventually led him back to full health. But he also said what he learned and has done in the aftermath of getting the injection has proved very important for him and his left shoulder.

PRP injections are much more common now then when Britton had his.

"It has already been three years since mine, there is more research now," Britton said recently. "It was so new, it would be something done in other countries. But in other countries they might be putting something else with that (injection) we are not allowed to take. With me, they took healthy plasma, spinning it and injecting those healthy blood cells back into the shoulder. There was nothing out of body put into it.

"When I got it done, Dr. (James) Andrews told me there wasn't a lot research on it but he told me he thought it was a way to help get blood flowing to the shoulder. The biggest thing for me was the time off and the rehab. It helped jumpstart it a little bit."

Since those type of injections were relatively new at that time, did Britton have any concerns about getting one?

"Not really," he said. "We didn't want to do a cortisone shot at that time. That might just mask a problem. We felt this was the best option to get some healing in there. We felt that was a good route to go then."

Orioles top pitching prospect Dylan Bundy had a PRP injection in his right elbow in April of 2013. When he resumed throwing, he found that, in his case, it did not alleviate his elbow problem and underwent Tommy John surgery two months later. In Britton's case, the PRP injection eventually did return his shoulder to health, and by the 2014 season, he was one of the best relievers in the American League.

"I think a lot of it for me was that rehab," Britton said. "When I got the injection, even two or three months later, it still didn't feel great. It was not a quick fix. That was one step in the process to get back.

"There are things now that I don't take for granted. I do the cuffs (exercises) after I throw to stay on top of my shoulder maintenance. Sometimes when you are younger you don't think you can get hurt."

Britton said he learned that his long-toss program might have not as beneficial as he thought, especially since the arm angle used to long toss is not the same as he uses on the mound in a game. So he made adjustments.

For pitchers, there are always adjustments and maintenance for the arm with so many injuries now and so many surgeries for both minor league and major league pitchers.

"Throwing is so unnatural," Britton said. "When I went through my rehab, Dr. Andrews felt certain types of long toss or throwing kids do at a young age caused an increase in injuries. Just the amount of throwing kids do. Some that don't play multiple sports throw so many innings and eventually your arm can break down."

On to Cleveland: The Orioles' seven-game road trip now moves on to Cleveland after Thursday's 3-2 win at Houston improved their record to 24-29. The O's didn't pin a loss on Dallas Keuchel, but they are 2-0 this year in games where he starts against them.

The Birds went 3-4 the last two years against Cleveland, going 1-2 both years at Cleveland.

The offense didn't produce much in Houston, scoring 10 runs and batting .203 in the series. They had 26 hits in the series. But Adam Jones hit a huge home run in the eighth inning to snap a 20-game homerless stretch. Over his last two games, Jones is 5-for-8. Maybe his bat will heat up again after a month of May when he batted .239 with a .556 OPS. Those numbers were .400 and 1.147 for Jones in April.