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====1964 season==== On April 14, Koufax made the only [[Opening Day]] start of his career, pitching a 4β0 shutout against the [[1964 St. Louis Cardinals season|St. Louis Cardinals]].<ref>{{cite web |title=St. Louis Cardinals vs Los Angeles Dodgers Box Score: April 14, 1964 |url=https://www.baseball-reference.com/boxes/LAN/LAN196404140.shtml |website=Baseball-Reference.com}}</ref> In his next start, he struck out three batters on nine pitches in the third inning of a 3β0 loss to the [[1964 Cincinnati Reds season|Cincinnati Reds]], becoming the first pitcher in Major League history to throw three immaculate innings.<ref name="9pitch9strike"/> On April 22, in St. Louis, however, Koufax "felt something let go" in his arm during the first inning, resulting in three [[Hydrocortisone|cortisone shots]] in his left elbow and three missed starts.<ref>[[#Leavy|Leavy]], p. 150.</ref> On June 4, against the [[1964 Philadelphia Phillies season|Philadelphia Phillies]] in [[Connie Mack Stadium]], Koufax threw his third career no-hitter, tying [[Bob Feller]] as the only modern-era pitchers to hurl three no-hitters. He needed just 97 pitches and faced the minimum 27 batters while striking out 12. The only full-count he allowed was to [[Dick Allen]] in the fourth inning. Allen walked and was thrown out trying to [[stolen base|steal]] second base; he was the Phillies' only baserunner that day.<ref>[[#Koufax and Linn|Koufax and Linn]], pp. 219β221; [[#Leavy|Leavy]], pp. 151β153.</ref><ref>{{cite web |last1=Aaron |first1=Marc |url=https://sabr.org/gamesproj/game/june-4-1964-sandy-koufax-puts-everything-together-in-third-career-no-hitter/ |title=June 4, 1964: Sandy Koufax 'puts everything together' in third career no-hitter |work=Society for American Baseball Research}}</ref> On August 8, during a game against the [[1964 Milwaukee Braves season|Milwaukee Braves]], Koufax jammed his pitching elbow while diving back to second base to beat a pick-off throw by [[Tony Cloninger]]. He managed to pitch and win two more games, but on the morning after his 19th win, a shutout in which he struck out 13 batters, Koufax woke up to find his elbow "as big as his knee" and that he could no longer straighten his arm. He was diagnosed by Dodgers team physician [[Robert Kerlan]] with traumatic [[arthritis]].{{efn|Dr. [[Frank Jobe]], inventor of the [[Tommy John surgery]], later disagreed with Koufax's diagnosis. He believed that Koufax suffered a torn [[Ulnar collateral ligament of elbow joint|ulnar collateral ligament]] but stated there were no means to diagnose or treat such an injury when Koufax was an active player.<ref>{{cite news |last1=Pouliot |first1=Matthew |title=Dr. Frank Jobe: 'It could have been Sandy Koufax surgery' |url=https://www.nbcsports.com/mlb/news/dr-frank-jobe-it-could-have-been-sandy-koufax-surgery |work=[[NBC Sports]] |date=July 14, 2012}}</ref>}}<ref>[[#Koufax and Linn|Koufax and Linn]], pp. 222β228; [[#Leavy|Leavy]], pp. 155β157.</ref> With the Dodgers out of the pennant race, Koufax did not pitch again that season, finishing with a 19β5 win-loss record and leading the National League with a 1.74 ERA and seven shutouts, and the majors with a 2.08 FIP.<ref name="bbref-skoufax"/>
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