MIAMI - The Phillies' difficult month got worse Tuesday night when Vince Velasquez left his start with an elbow injury after throwing just 19 pitches against the Marlins. The team said he has a right elbow flexor strain.

Velasquez seemed to grab his right side after J.T. Realmuto flew out to center field for the first out of the second inning. Manager Pete Mackanin, pitching coach Bob McClure, and athletic trainer Scott Sheridan met Velasquez at the mound and removed him from the game.

The righthander's velocity significantly dipped after he struck out Giancarlo Stanton with a 95-mph fastball in the first inning. None of his next nine fastballs reached even 92 mph. Velasquez spent time last season on the disabled list with a right biceps strain. He was relieved Tuesday by Mark Leiter Jr.