Eflin says elbow injury felt like 'my heart was ripped out of my chest'

BALTIMORE -- As an 11-year MLB veteran, Zach Eflin has endured plenty of injuries. The 32-year-old right-hander knows how to go through the rehab process, especially after spending this past offseason recovering from the lumbar microdiscectomy (back surgery) he underwent last August.

But Eflin had never felt anything like the elbow pain he experienced in the fourth inning of his 2026 debut for the Orioles on March 31.

"It just felt like a hamstring cramp in my elbow. Literally out of nowhere," Eflin said Sunday morning prior to the O's series finale vs. the Giants at Camden Yards. "I had never felt anything in my elbow before, and anything minor, I’ve always pitched through, had no issue with. But this, I just couldn’t extend my arm. I couldn’t do anything. So it was frustrating."

It didn't take long for Eflin to realize what would likely come next. After getting initial imaging done, he met with Dr. Keith Meister in Arlington, Texas, on April 7, then underwent Tommy John surgery two days later (on his 32nd birthday).

Eflin's season is already over after only 3 2/3 innings and 73 pitches in one start against the Rangers.

"I knew something had happened on the field. Really just kind of felt like my heart was ripped out of my chest," Eflin said. "I was going through so much this offseason to come back on time, and I’d honestly never felt better in my career before. And I think some of that had to do with the added mobility that I gained in Spring Training, and that outing, from getting my bone spur out of the back and the herniation fixed."

The results had been there to back Eflin's claim. He had a tremendous spring, tossing 7 1/3 scoreless innings over two Grapefruit League starts and proving to the O's he was ready to go for the start of the season, even though he was the last starter to get into game action. Then, Eflin racked up seven strikeouts and had allowed only one run (a solo homer by Ezequiel Duran) in his outing vs. Texas.

Although Eflin won't pitch again this year -- recovery from Tommy John surgery typically takes anywhere from 12-18 months -- he wants to be around the Orioles as much as possible. Since getting dealt from Tampa Bay to Baltimore at the 2024 Trade Deadline, he has stated multiple times how much he enjoys being in Baltimore and with his teammates in the clubhouse.

Last year, Eflin had an injury-plagued season that featured three stints on the injured list and resulted in him posting a 5.93 ERA over 14 starts. He became a free agent after the season and re-signed with the O's on a one-year deal worth a guaranteed $10 million, making it clear afterward they were the top team on his list.

Eflin's strong desire to pitch for the Orioles, along with the support he consistently shows the other players on the club, made the announcement of Tommy John surgery tough news to take for his teammates.

"You hate it for him, but he’s been extremely supportive," infielder Jeremiah Jackson said. "He’s in here with us, and it kind of feels like we didn’t lose him. So yeah, he’s been awesome, he’s been taking it well and we’re rallying behind him."

"Something I've learned is you don't bet against Zach Eflin," manager Craig Albernaz said. "I know he's going to attack the rehab process as the pro he is, and we love having him around the clubhouse, because he's a great leader."

Eflin has an uncertain future, and not only because of his health. He has a mutual option with the O's for the 2027 season worth $25 million, which can be bought out for $2 million. It seems likely that will be declined by Baltimore, and Eflin will sign a two-year deal, whether it's with the Orioles or a different team.

After Eflin's back surgery last August, he said he "absolutely" wanted to return to Baltimore. On Sunday, he was asked the same question.

"It’s an, 'Absolutely,' again," Eflin said. "It’s hard to sit here and wonder where I’m going to be. I’m not a cat, I don’t have nine lives. But it’s wherever I’m called to serve, I’m going to do that. If it’s here, if it’s somewhere else, whatever it may be."