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As Adbert Alzolay goes on the IL, Chicago Cubs are concerned while awaiting test results on his elbow

ATLANTA — The typically exuberant post-save Adbert Alzolay appeared somber.

Despite recording his first save in nearly a month to secure Sunday’s win in Pittsburgh, Alzolay’s emotions were restrained as the Chicago Cubs celebrated the extra-inning victory. Known for his fired-up first pump, Alzolay went through the on-field handshakes with his right arm at his side, substituting with his mitt as he connected with teammates down the line and into the dugout.

His abnormal demeanor gained context Monday when the Cubs placed Alzolay on the 15-day injured list with a right forearm strain before their 2-0 loss in the series opener against the Atlanta Braves. Right-hander José Cuas, who had been optioned before Sunday’s game to clear a spot for Kyle Hendricks, was recalled to replace Alzolay.

Alzolay wasn’t available to speak to media Monday because he was undergoing medical testing. He first experienced tightness in his elbow while warming up to come in for the 10th inning Sunday, pitching coach Tommy Hottovy said, and Alzolay thought it would go away as he got loose.

But his arm never got loose during the outing, prompting him to tell the team after the game. The Cubs won’t know the severity of his injury or how long he might be out until they receive test results.

Manager Craig Counsell expressed concern given the circumstances. Alzolay becomes the 14th Cub to spend time on the IL this season and is one of five relievers currently hurt.

The Cubs made a move to reinforce the bullpen Monday night by acquiring right-hander Tyson Miller from the Seattle Mariners for minor-league infielder Jake Slaughter, a source confirmed to the Tribune.

Miller, originally a fourth-round pick by the Cubs in 2016, was designated for assignment Friday. The 28-year-old had a 3.09 ERA and 125 ERA+ in nine games with the Mariners this year, striking out 12 and walking only one in 11 2/3 innings.

“Anytime you have a number of your players hurt, you’ve got to make adjustments, and we’ve got to be willing to adjust on the fly and adapt on the fly and change directions when needed,” Counsell said. “Our guys have done a really good job of that, and that’s what periods like this require. But it’s part of a baseball season, teams go through it and you just do your best with it.”

Hottovy sees a positive that Alzolay’s arm hadn’t bothered him previously this season. However, Alzolay’s injury history adds to the worrisome nature of the ailment. He spent 19 days on the IL in September with the same injury.

A tested, beat-up bullpen didn’t leave Counsell with many options in the 10th Sunday. Alzolay essentially was the last pitcher in the bullpen as the Cubs ideally would have stayed away from right-handers Hayden Wesneski and Ben Brown unless forced to use them if extra innings continued.

Alzolay was determined to answer the call in that moment and didn’t let the game get away from him after a leadoff two-run homer en route to recording his fourth save.

“That’s what you love about Adbert,” Hottovy said. “Obviously he’s gone through some tough stretches this year and he’s been working his tail off to get back, working on a lot of mechanical things, doing some drill work, all the things that he knows he’s going to need to clean up to be the best version of himself.

“And to not feel you’re at your best and still be willing to take the ball and go out there and compete and give everything he has, literally, on the field, he knows that was the best thing he could do for the team in the moment.”

While Alzolay fought through the tightness he was experiencing Sunday, Hottovy acknowledged it’s a difficult balance between pitchers being honest with him and the staff about how they’re feeling and knowing when they can push through while not feeling 100%.

“We’re always having to live in this world where we’re constantly focused on winning the game tonight, but also what that does for the remainder of the week, remainder of the series, month, whatever,” Hottovy said. “You’re not going to feel good every time, and part of this process for these younger pitchers is to understand what is soreness that I can pitch through and work through, what is soreness or stiffness that I probably need to try to avoid pitching through.

“Unfortunately for a lot of guys, you don’t really know until you experience it, and everybody’s different. Everybody’s pain tolerance is different. Everybody’s mechanics are different. Everybody puts stress on their bodies in different ways.”

Alzolay’s struggles before his injury complicated the Cubs’ high-leverage options. In 18 appearances, he posted a 4.67 ERA and surrendered six home runs in 17 1/3 innings, already exceeding the five homers he gave up in 64 innings last year.

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Alzolay had been working on mechanical issues stemming from generating too much thoracic extension early in his delivery. He essentially was creating a lot of early movement with his chest and upper body. It changed the way his body moved and how he breathed.

He had been doing medicine ball drills and belt work to create stability and take stress off of not throwing. He sounded encouraged about his mechanics postgame Sunday.

“Diaphragmatic breathing is such an important thing for pitchers,” Hottovy explained. “It can create space for your scapula and everything to move. … What has made him so good is that he can use his lower body really athletically and then just let that upper body happen naturally.”

Alzolay had gotten out of sorts, though, especially when throwing his slider early this season. The Cubs noticed the pitch had a lot more depth and his arm slot was climbing when throwing it. Hottovy didn’t rule out that by mechanically getting out of rhythm and opening his chest too much, Alzolay might have strained another area along the kinetic chain — in this case his right forearm and elbow.

“Some of that stuff could have definitely played into it,” Hottovy said. “He’d been trending in the right direction, working a lot on being able to stay compact and tight there, but he could have already put a lot of strain on that early in the year and then trying to work your way out of it.”