Kansas City Royals left-hander Cole Ragans left Wednesday's start against the Cleveland Guardians with tricep and elbow soreness, the team announced.
Ragans exited after throwing 58 pitches and allowing one hit in three innings. He was replaced by Luinder Avila.
The 28-year-old is in the midst of a down year, posting the highest ERA of his career (5.29) despite maintaining his normally high strikeout rate (11.4 K/9).
Ragans has a history of injuries, having had Tommy John surgery twice. He also missed time last season with a rotator cuff strain.
