With his head down, Zach Eflin walked with purpose — off the mound, down the dugout steps and straight into the tunnel to the clubhouse.

The Orioles right-hander was trailed by trainer Scott Barringer, and while it wasn’t immediately clear what Eflin’s issue was, the fact he was leaving at all was a worrisome sign for Baltimore. Later, the Orioles announced that Eflin was dealing with right elbow discomfort.

Eflin had just completed a healthy spring, proving that he was back at his best following an August back surgery. He began Tuesday’s game against the Texas Rangers in fine form. But then something seemed not quite right in the fourth inning, and Eflin’s night ended in a hurry.

The Orioles’ relievers, thrown into the fire after two nights of shortened starts, couldn’t hold the Rangers in check. Grant Wolfram, Yennier Cano and Yaramil Hiraldo combined to allow six runs in 3 1/3 innings and the Rangers ran out with a 8-5 victory.

Some of the Orioles’ hitters came through with large hits. Pete Alonso hit his first home run for the club and Gunnar Henderson tied the game in the fifth with a two-run double.

But Texas used a three-run homer from Danny Jansen against Hiraldo to build its lead again. Corey Seager cranked a homer against right-hander Anthony Nunez in the ninth, too. With that surge, the Rangers sealed a series win before Wednesday’s matinee.

The greater concern, in the grand scheme of Baltimore’s season, came earlier.

With two outs in the fourth inning, Eflin issued a walk to Evan Carter. That prompted pitching coach Drew French to jog to the mound for a visit, and it turned into an extended discussion. But Eflin remained, threw one pitch — a 76-mph breaking ball to Ezequiel Duran, who homered off Eflin earlier — and catcher Adley Rutschman turned toward the dugout.

Out came Barringer and manager Craig Albernaz, and after a conference, Eflin made his way off the field.

The health of the rotation to this point is part of the reason why the Orioles optioned right-hander Dean Kremer to Triple-A Norfolk. With off days built into the schedule, a six-man rotation didn’t make sense, and president of baseball operations Mike Elias said the Orioles wanted to keep Kremer stretched out as a starter in the minors rather than putting him on a bullpen schedule.

The presence of Kremer, who is scheduled to pitch Friday in Norfolk, could be a massive help should Eflin be injured for any significant period of time.

Eflin dealt with multiple injuries in 2025. He was placed on the injured list for a lat strain in April and his back discomfort prompted another injured list stint in June. By July, the back discomfort continued and Eflin’s season was cut short.

This winter, when Eflin returned to the Orioles as a free agent, he said the back surgery helped him live his everyday life better, let alone throw a baseball. He looked great during spring training, too, and earned a place in the initial rotation.

Eflin has never been placed on the major league injured list with an elbow injury. In general, elbow discomfort is an ominous injury pronouncement.