MEANS: John Means of the Baltimore Orioles pitches in the first inning against the Cincinnati Reds at Great American Ball Park on Saturday, May 4, 2024, in Cincinnati, Ohio. Dylan Buell/Getty Images/TNS

Few in baseball have lived the highs that pitching in the major leagues can grant more than John Means. Even fewer have experienced the lows.

Means was an All-Star in 2019. He entered the history books in 2021 when he pitched the sixth no-hitter in Baltimore Orioles history.

He took part in two clubhouse celebrations in 2023.

But a promising career was temporarily paused because of a torn elbow ligament, requiring Tommy John elbow reconstruction surgery in 2022.

His return was delayed because of setbacks. And now he’s facing the same arduous road back after going under the knife again for the same procedure.

Speaking with the media Saturday for the first time since his surgery June 3, Means said, “Baseball is beautiful and horrifying at the same time.”

And perhaps no one can attest to that more than Means.

But the 31-year-old left-hander isn’t going to give up now, hoping the revision surgery can fix his ulnar collateral ligament for good – “get it right this time,” he said – and return him back to the pitcher he was when he was Baltimore’s ace during the rebuild.

“No, I was going to get the second one no matter what,” Means said when asked if he considered retiring. “I still want to pitch, honestly. I would like to fail on the field before I give it up. I feel like if I go out there, I can still pitch. I still feel really confident in my ability, just got to hope the elbow can keep up.”

The stats back up Means’ belief in himself.

He owns a career 3.68 ERA across 401 big league innings, but he was even better after his first Tommy John surgery.

In eight starts since September, Means posted a 2.64 ERA and 0.790 WHIP, stellar numbers in a small sample that, if able to be extrapolated over a full season, would make him one of baseball’s best southpaws.

Means will be a free agent this offseason, adding a stinging element, as he would’ve been due a solid payday had he remained healthy. Now, with his contract with the Orioles up at the end of the season, it’s unclear what jersey Means will wear next and what opportunities he’ll be presented.

“I don’t know what’s going to happen,” he said. “I don’t want to think about it right now. We’ll just kind of see where it goes. Like I said, I feel really confident about my ability to pitch on the field. I just got to have the elbow keep up.”

He was 2-0 with a 2.61 ERA in four starts this year, including his final one in St. Louis.

Means said his elbow had been bothering him before that outing, and he was hoping as the season progressed, his elbow would “loosen up.”

He knew something was wrong in the bullpen that afternoon in late May, but he pitched through the pain to not “screw the bullpen” in the middle of a difficult stretch with few days off.

“It didn’t feel any better than the day after I pitched the last game,” he said.

Means’ second Tommy John surgery, which requires a 12-to-18 month recovery, came less than 26 months after his first. Shortly after Means’ first surgery, the Orioles promoted catcher Adley Rutschman and suddenly became one of the best teams in the American League.

Throughout Baltimore’s magical 2023 campaign, Means methodically rehabilitated his elbow, hoping to return in the summer.

An upper-back injury delayed that, but he came back in September and posted a 2.66 ERA in four starts to help lead the Orioles to their first American League East title since 2014. But his elbow flared up before the AL Division Series, and he missed the beginning of the 2024 campaign recovering.

Elbow injuries have been on the rise this century, especially the past decade.

The Orioles are far from the only ballclub dealing with a rash of pitcher injuries, and the news of Kyle Bradish’s sprained UCL likely won’t be the last ailment Baltimore has to overcome in 2024.

“I don’t know if there’s one thing specifically,” Means said when asked about the rise of elbow injuries. “There’s a lot of factors – the (velocity’s) up, there’s more pitches per plate appearance. There’s a lot of factors that affect it. I think mine’s kind of an anomaly: I throw 91 (mph) and my pitches don’t move a whole lot. I think mine’s pretty fixable, but who knows?”

The first few weeks recovering from Tommy John surgery are the easiest, but Means is all-too familiar with the grueling, lonely and monotonous path ahead.

He’s not sure whether it will be easier this time since he knows what to expect, or if it’ll be harder because he has to do it all over again.

“Hopefully, this one is a little easier,” he said. “I’ll try to put a little less pressure on it this time.”