Phillies right-hander Jake Arrieta has been trying to pitch through bone spurs in his elbow for much of and perhaps all of the 2019 season. As you're about see, the results have been less than optimal: 

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Arrieta is coming off a particularly bad start against a poor Giants lineup on Sunday, and in related matters his elbow condition doesn't seem to be improving or even holding steady. Arrieta's stated intention had been to pitch through the injury and delay surgery until the offseason, but now that's sounding less and less likely. Via Jim Salisbury of NBC Sports Philadelphia, here's what Arrieta said of his elbow after his Sunday outing: 

"Yeah, it hurts every day. Today, I lacked the ability to throw any off-speed stuff with effectiveness and they made me pay for it."

Arrieta also said that he and the team will discuss the way forward on Tuesday. In other words, Arrieta's body may not allow him to put off surgery until the winter, which in turn would deliver a blow to the Phillies' rotation. 

While those overall numbers for 2019 are hardly vintage Arrieta, they're also not necessarily bad for a starter in 2019. Thus far, Arrieta has pitched to a 98 ERA+ this season, which is roughly average for a starting pitcher. On the other hand, if Arrieta's elbow has worsened to the extent that Sunday is his new normal, then he's not helping the team. Compounding that disappointment is the fact that the 33-year-old Arrieta is in the second year of a three-year, $75 million deal with the Phillies. 

The Phillies did add veteran lefty Jason Vargas leading up to the July 31 trade deadline, which allowed manager Gabe Kapler to shift Zach Eflin to the bullpen. If Arrieta is out, that would presumably force Eflin back to the rotation, where he struggled this season. That, in turn, would thin out the bullpen. 

At the moment, the Phillies, despite heavy investments in the roster this past offseason, are two games out of wild-card position in the NL and behind three teams -- the Mets among them. In matters related, injuries have hit the Philly pitching staff hard, and the next blow could come this week, when Arrieta and Phillies presumably make a decision on the rest of his season.