KANSAS CITY, Mo. — The Minnesota Twins have made the decision to send right-handed pitcher Joe Ryan back to Minneapolis for a medical evaluation with team doctor Chris Camp, manager Derek Shelton announced Wednesday afternoon. The move comes as Ryan has been battling discomfort in his back and glutes, which has evidently affected his performance on the mound.

“It’s back and glute issues,” Shelton explained before the second game of a three-game series against the Kansas City Royals at Kauffman Stadium. “We need to figure out what’s going on.”

The uncertainty surrounding Ryan’s health raises questions about his next start, which is currently scheduled for Sunday. Shelton admitted that whether Ryan takes the mound that day remains to be seen.

Ryan’s recent outings have been concerning. On Tuesday night, he struggled once again, allowing five runs (four earned) over 5⅓ innings as the Twins fell 8-2 to the Royals. That marked the third straight start in which Ryan has been ineffective. Since the All-Star break, his earned-run average has ballooned from a stellar 2.85 to 3.65. Over his past three appearances, dating back to July 20, he has surrendered 16 earned runs and seven home runs. Overall, in 23 starts this season, Ryan has recorded 138 strikeouts across 125⅔ innings, with a 3.65 ERA.

Ryan had previously experienced tightness in his back, prompting an MRI back in February. Despite that, he was able to begin the regular season without missing time. After Tuesday’s loss, Ryan did not complain of pain, but he expressed frustration about his inability to replicate his delivery consistently. He also noticed that his four-seam fastball velocity had dropped by an average of 1.3 mph, according to Statcast data. He wasn’t sure what the root cause was, and he sounded uncertain about whether he had truly recovered from the arm fatigue that led the Twins to skip one of his starts in late July.

“We owe it to him, and to us, to find out what he’s feeling,” Shelton said. “Most importantly, we have to do what’s best for Joe Ryan to be healthy.”

Ryan has a history of injuries. He made 30 starts last season but missed the final two months of the 2024 season with a Grade 2 teres major strain in his right throwing shoulder. Additionally, he was not fully healthy during the 2023 playoffs after suffering a groin injury in August.

In other Twins news, right-hander Dean Kremer made his first start for the team on Wednesday night. Kremer, acquired from the Baltimore Orioles for minor-league outfielder Jhomnardo Reyes, admitted to feeling jitters about starting a new chapter. “I feel jitters about being in a new organization, I feel jitters about it being a start day,” Kremer said. “But it feels like the normal jitters.”

Kremer had a rough season with Baltimore, posting a 6.50 ERA in seven starts. He also dealt with a quad injury in April and was sent to the minors toward the end of spring training, despite being a rotation mainstay since 2022. His results were skewed by his final two starts, where he allowed a combined 14 runs against the Boston Red Sox and Detroit Tigers. However, there are reasons for optimism. In 106 starts from 2022 through 2025, Kremer had a 3.95 ERA. His home run-to-fly ball ratio this season was an abnormally high 26.7%, compared to his career mark of 12.3%. He allowed 11 homers in 36 innings, many of them on poorly located four-seam fastballs. His expected ERA of 4.93 is closer to his career xERA of 4.59 and actual ERA of 4.37. His fastball velocity is near his career average, his walk rate is in line with norms, and his strikeout rate has risen to 24.8%. His splitter has been his best pitch.

“I don’t know about it being a new season for me,” Kremer said. “But it’s definitely a clean slate.”

Meanwhile, third baseman Royce Lewis is beginning to find his rhythm. On Tuesday, he went 4 for 4 with a double, tying his career high for hits in a game. That performance boosted his slash line to .232/.308/.418, and he has reached base safely via hit or walk in a career-best 15 consecutive games. Over the past 20 games since July 9, Lewis is slashing .296/.363/.563 with four home runs, 10 extra-base hits, eight walks, and 15 strikeouts. His weighted on-base average now stands at .316, making him just above league average as a hitter.

Lewis has come a long way since a slow start that included a humbling demotion to Triple-A St. Paul and a knee injury. Since then, he has refined his swing mechanics and regained confidence. “It probably started since being at Triple-A, when I went down, and made some good adjustments with (swing) path stuff,” Lewis said. “I’ve felt more like myself.”