'Heart ripped out of my chest': Tommy John surgery devastating for Zach Eflin

BALTIMORE — Zach Eflin did not come this far to go right back to the starting line. That’s why, when he felt his elbow seize and his extension vanish not quite four innings into his 2026 season, what came next hit even harder.

"Really," he says, "just felt like my heart was ripped out of my chest."

Eflin underwent Tommy John surgery to reconstruct his elbow April 8, eight days after leaving his first start of the season in the fourth inning. His 2026 season will consist of just 11 outs recorded, as he undergoes the grueling rehab thousands of pitchers before him endured.

Yet this elbow reconstruction marks Eflin’s second major surgery in eight months: In August, he underwent a lumbar microdiscectomy, a back procedure that was to sideline him four to eight months.

It was brutal timing: Eflin was set to hit the free agent market in just two months. At the time of his back surgery, he expressed an interest in returning to the Baltimore Orioles, even as he faced major uncertainty undergoing a major procedure at 31.

Yet the Orioles made the reunion happen, signing him in December to a one-year deal that guarantees him $10 million – $2 million coming on a buyout of a $25 million 2027 option.

With trade and free agent acquisitions Shane Baz and Chris Bassitt aboard, Eflin figured to start the year on the IL as he recovered from back surgery. Yet he startled the club with his health and performance in spring and cracked the opening rotation.

"I never felt better in my career before," says Eflin Sunday, April 12 in his first public comments since getting injured. "Some of that had to do with added mobility I gained in spring training, from getting my bone spur out of the back and the herniation fixed."

Zach Eflin felt great in his March 31 start against the Texas Rangers until his elbow gave in the fourth inning.

Now Eflin, who has won 68 games in 189 career starts, and accumulated 12.9 WAR, wonders if the elbow was ready for such mobility. He was rolling in his start against the Texas Rangers, striking out seven of the 17 batters he’d faced when he felt the elbow seize.

"I had felt amazing for three innings. Then in the fourth inning, it took one pitch," he says. "An up-and-away heater or cutter and it felt like a hamstring cramp in my elbow. Literally I’d never felt anything in my elbow.

"I couldn’t extend my arm. I couldn’t do anything. It’s frustrating, but it’s reality and you’re going to live with it."

Once again, Eflin expressed a desire for yet another reunion with Baltimore. It makes sense on one level: The club will surely decline his $25 million option, but since they owe him a $2 million buyout, it perhaps enhances the odds they can fold in another year that takes into account his likely absence until roughly midseason in 2027.

Either way, Eflin has an idea the path he’s embarking upon. It’s just a bit devastating that he’s back at square one again so soon.

"Take rehab seriously. Go to war every single day trying to get better," he says. "Continue to lift people up in any way I can. Serve wherever I’m called. At the end of the day, do everything I can to make sure my entire body’s ready the next time I come out.

"Which is what we did this offseason. It’s kind of a head-scratcher for me. I know God’s timing is always perfect and I’ll serve wherever called."

This article originally appeared on USA TODAY: Zach Eflin injury, Tommy John surgery devastating for Orioles pitcher