PITTSBURGH -- Adrian Houser winced and drew a visit from the athletic trainer. It was a scene that has unfolded too many times for the Brewers’ liking this season.

Houser departed his start in Thursday’s 8-7 loss to the Pirates at PNC Park after 42 pitches complaining of tightness on the top and back of his right elbow, the latest setback for a Milwaukee rotation that’s already had three starters land on the injured list this season. Houser will become the fourth on Friday, according to manager Craig Counsell.

“Any time we take a pitcher out of the game with an elbow injury, there's reason to be concerned, and this was concerning enough to send him back to Milwaukee immediately,” Counsell said. 

Houser, who already experienced the worst-case scenario when it comes to elbows after he underwent Tommy John surgery in 2016, said he was encouraged by the on-site strength tests administered in the clubhouse. But the injuries are adding up for Brewers starters. 

Freddy Peralta is sidelined beyond the All-Star break by a shoulder injury, Aaron Ashby is currently on the IL with a forearm strain and Brandon Woodruff just returned from the IL this week after missing most of June with a sprained ankle and a circulation issue in the fingers of his pitching hand. 

The good news for the Brewers is that Woodruff brought electric stuff in his return to action on Tuesday against the Rays at Tropicana Field, and that Ashby is trending toward a return from the IL and a start against Pittsburgh on Saturday. The bad news is the new concern about Houser, who had been scuffling in the runup to Thursday’s early exit to the tune of a 6.54 ERA and an .859 opponents’ OPS over his previous six outings. 

Against the Pirates, Houser surrendered back-to-back home runs to rookies Oneil Cruz and Jack Suwinski in the second inning for a 3-0 Pittsburgh lead, then the right-hander left a 3-2 game in the third following a one-out walk to Daniel Vogelbach. 

Brent Suter took over as the Brewers plotted how to navigate the remaining innings. They managed to make it a ballgame with six doubles and a Christian Yelich triple among their 12 hits, scoring three times in the ninth and putting the potential go-ahead runner on base before the Pirates escaped.

Pittsburgh’s decisive run came from catcher Michael Perez, who delivered the Pirates’ second three-homer performance in as many games, and the team’s third this month. The Bucs are the first team in AL/NL history to have a trio of three-homer games in one calendar month.

“Perez, I guess it was his night. My pitch wasn’t even a strike,” said Suter, who surrendered the first of Perez’s trio on an inside pitch in the fourth inning. “It wasn’t where I was trying to go, but you’ve just got to tip your hat sometimes. For us to have everything that happened, to come back and have the [potential] winning run at first base says a lot about the fight of this team.”

Houser will be the 20th IL move for the Brewers since Opening Day and the ninth player currently sidelined.

“We have to kind of play the hand we're dealt here, unfortunately,” Counsell said. “We’ll hope for the best [on Friday]. Hopefully it's not a lengthy stay and we'll get him back quickly, but in the meantime we'll have to cover those innings.”

The Brewers have their stopper, Corbin Burnes, scheduled to start on Friday night, followed by Ashby’s expected return from the IL on Saturday and then Woodruff’s second start off the IL on Sunday.

Milwaukee has options to fill Houser’s spot. Right-hander Jason Alexander, who originally joined the rotation when Woodruff went down, has delivered a 3.82 ERA in 30 2/3 innings so far, while Chi Chi González has made two spot starts with Ashby down. Top pitching prospect Ethan Small is also available at Triple-A Nashville; he made his Major League debut on Memorial Day in place of Peralta.

“It’s part of this team, the camaraderie and staying connected,” Suter said. “We feel bad for the guy going down, but it’s the next guy up.”

Houser was remaining hopeful.

“Hopefully it’s just capsule tightness or something like that,” he said. “The tests came back and it seemed like they were all right. We’ll see what happens when they look at it. Hopefully, I’ll just be down a couple of days to get the inflammation out of there and then I can be back in there.

“I don’t feel like we had this many injuries last year, but it’s part of it. We know what we’re signing up for when we play baseball. So we just have to roll with the punches, keep carrying on and putting the work in.”