ST. PETERSBURG -- Royals left-hander Cole Ragans is likely headed for yet another elbow surgery.
Manager Matt Quatraro said before Tuesday’s game against the Rays that the team anticipates Ragans will need a surgical procedure to address the left elbow impingement that has kept him on the injured list since May 8.
Quatraro added that he’s not sure what type of elbow procedure Ragans needs or whether he will be able to return this season. More will be known after the lefty sees another doctor in the coming days.
“It’s awful,” Quatraro said about the news. “We talk about it all the time when guys get hurt; these guys grind and work, and do it year-round to put themselves in the best position to go out there and compete. Clearly, it's a blow for him and for us. I mean, it’s our Opening Day starter the last few years. That's a really tough one to swallow for him and his family.”
It’s worth noting that Ragans has already made it back from two Tommy John surgeries -- one in 2018 and another about 14 months later in May 2019. He underwent both operations while he was still a Rangers prospect.
Ragans eventually became one of the best pitchers in the Majors with the Royals, finishing fourth in the American League Cy Young voting in 2024.
However, injuries have really hampered Ragans since the beginning of 2025. After being limited to just 61 2/3 innings last year, because of a left groin strain and a left rotator cuff strain, Ragans made it through just 35 1/3 innings this season before suffering his current injury during a start against the Guardians on May 7. Ragans was specifically diagnosed with valgus extension overload -- a condition commonly called “pitcher’s elbow” that’s characterized by back- and middle-elbow pain related to repetition in throwing athletes.
Ragans has experienced multiple setbacks in his recovery, the most recent of which occurred on June 12, when he had to cut a catching session short because his left arm didn’t feel great.
Ragans was subsequently shut down from throwing, and an MRI exam performed three days later came back with inconclusive results. He has seen multiple doctors recently to help determine his next steps, but his last visit confirmed that he needs yet another surgical procedure on his powerful left arm.