James Paxton’s return to the Mariners never made it out of the second inning, and it was for the worst, yet all too familiar, reason — injury.

Paxton exited his first outing of the 2021 season with one out in the second inning Tuesday night vs. the White Sox at T-Mobile Park with what the Mariners later announced as “left elbow discomfort.”

Those three words are not something you want to hear for any pitcher.

After the game, a 10-4 Mariners loss, both Paxton and manager Scott Servais referred to it more as forearm pain. He will have a MRI on Wednesday morning.

“In the second inning there, I can’t remember exactly, but I felt it coming on,” Paxton said. “It just got worse and worse and it got to a point where I couldn’t throw pitches.”

A strained flexor tendon in his forearm/elbow area ended Paxton’s 2020 season in mid-August. He blamed the injury on compensating for a lack of leg strength brought on by back surgery in February. But during the entirety of spring training, Paxton never exhibited any issues with his elbow or forearm until Tuesday night.

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“Everything was feeling good, but I guess just the stress of in-game was just a little bit more than it was ready to handle tonight,” he said.

Paxton said he’d had no issues with the forearm during the offseason or during spring training.

“Well, it’s kind of been a process through the recovery of my flexor strain from last year,” he said. “Throwing this offseason, going to bullpens, getting into spring training games. And that process was all going well, I was going through the levels and kind of building it up. I came in tonight and I was pretty confident that I was going to be good, but it turned out that it just was a little bit too much for what my flexor was ready for, I guess.

Paxton said this felt different than the flexor strain.

“With the flexor strain before, there was a lot more pain than there is right now,” he said. “I’m feeling pretty optimistic that this could be a pretty quick thing. Obviously, I don’t know much right now. We’re getting some imaging done. And we’ll know more in the coming days.”

The injury came after his 24th pitch of the game and ninth pitch of the second inning.

The pitch was a 92 mph fastball that started out low and leaked well outside of the strike zone. It was an odd result considering his fastball had been sitting at 94-95 mph in the first inning with life and command.

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The reason for the anomaly became evident when Paxton pushed his hip area, wandered off to the first base side of the mound and leaned over with his left hand and glove on his knees in obvious discomfort.

Replays showed Paxton grimacing in pain on the pitch as he let it go and also showed that he was bothered by something on the previous pitches.  

A disappointed James Paxton leaves the game in the second inning against the White Sox with an unknown injury.  The Chicago White Sox played the Seattle Mariners Tuesday, April 6, 2021 at T-Mobile Park in Seattle, WA. 216787 (Dean Rutz / The Seattle Times)

Servais and Kyle Torgerson, the Mariners head athletic trainer, immediately went to the mound to check on Paxton.

“Watching very closely with Pax, I’ve seen him so much over the years and you see right away something’s not right,” Servais aid. “He’s disappointed and he felt something in his forearm, and at that point, the night is over, just shut it down and see what the doctors have to say.”

After a very brief conversation, a clearly frustrated Paxton walked off the mound with Torgerson with the crowd offering sympathetic applause.  

He’s dealt with plenty of injuries in his career and loathes the labels of being fragile or injury prone.

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“It’s just frustrating,” he said. “I feel like for me, it’s kind of been one thing after another. And I work really hard and do everything that I can to be out there, continue to do so. Hopefully I can catch a break and stay healthy for a good chunk of time in the future.”

Servais has watched Paxton battle through some injuries, including fluke plays that included being struck on the pitching arm by a 95-mph fastball in 2018. He also know how much time Paxton put in this offseason to get back to full strength for 2021. There was nothing but optimism this spring.

“He’s very talented player and a guy that we’re excited to have back,” Servais said. “I know how much work the guys put in when they are coming back from injury, the work they put in in the offseason to try to get themselves ready to make the long journey and survive throughout the whole season, health-wise. And it is frustrating for them. The guys care. I do know when you go down it’s a journey to get back out on the field again. I don’t want to go down that that rabbit hole. We’ll find out what the doctors have to say tomorrow and then we’ll go from there.”

Paxton cruised through the first inning, getting a weak pop-up from leadoff batter Adam Eaton and then struck out Luis Robert and Jose Abreu swinging.

He was replaced by lefty Nick Margevicius, who gave up a three-run homer to Zack Collins with one of those runs charged to Paxton.

The injury to Paxton does add some skepticism to the Mariners’ decision just before opening day to move him back to the No. 5 spot in the rotation instead of the No. 2 spot. Servais they wanted to give Paxton extra rest after a spring training where he made just two Cactus League starts due to work visa issues that forced him to pitch in simulated games on the backfields of the Mariners’ complex instead.

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But both Paxton and Servais said that it was just for extra rest given his weird spring training pitching schedule.

“No, not that I’m aware of,” Servais said of any prior forearm issues. “We wanted to be cautious coming into the outing tonight. We gave him a couple extra days, but his bullpens and everything had been fine leading up to that.”