Forearm Flexor Strain in MLB Pitchers Linked to UCL Surgery Risk

This retrospective cohort study (2015-2024) used covariate-matched survival analysis to compare 123 Major League Baseball pitchers who returned to play after a nonoperatively managed forearm flexor strain against 246 matched controls without such a strain. The study reported that pitchers returning from a flexor strain had elevated short-term risk of subsequent ulnar collateral ligament (UCL) surgery within one year compared to matched controls, with longer recovery time associated with progressively lower UCL surgery rates. The authors noted that because strain grade, UCL integrity, and associated medial elbow pathology were unavailable, return-to-play timing should be interpreted as a risk marker rather than evidence that delayed return is independently protective.

Most relevant for: Major League Baseball pitchers recovering from a nonoperatively managed forearm flexor strain and clinicians managing their return to play.

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