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Greg Holland has been shut down the rest of the 2015 season

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Tommy John surgery looks like a strong possibility.

Rick Osentoski-USA TODAY Sports

The Royals have announced that closer Greg Holland has been shut down for the remainder of the season due to concerns about his elbow. Holland was recently demoted from his closer's role after ineffectiveness over the last few months and a significant decline in velocity. According to MLB.com writer Jeffrey Flanagan, Holland's elbow will be examined next week by Dr. Neil ElAttrache in Los Angeles.

Greg Holland is a two-time All-Star who has 125 saves over the last three seasons. He has struggled this year with a 3.83 ERA and a sharp decline in strikeout-to-walk ratio down to 1.88, but has converted 32-of-36 save opportunities. Holland has been particularly ineffective later in the season, allowing 12 runs in his last 17 1/3 innings.

Elbow injuries are commonly associated with an injured ulnar collateral ligament, which requires Tommy John surgery. If that is the diagnosis, that will keep Holland out the entire 2016 season.  Holland has one more year of arbitration-eligibility before he is eligible for free agency after the 2015 season. He is due to earn over $10 million in arbitration, although if he is out for the year, he becomes an obvious non-tender candidate.

UPDATE: It would appear that Greg Holland's elbow injury will indeed require Tommy John surgery:

Further, a wrinkle in the story involves the Royals having sought a medical examination of Greg Holland, with the player refusing.