Washington Nationals starting pitcher Joe Ross (41) left his first rehab start on Tuesday after just three innings, citing renewed elbow tightness. Brad Mills-USA TODAY Sports

Nationals starter Joe Ross left his first rehab start on Tuesday after just three innings, citing renewed elbow tightness. The righty went for an MRI on Wednesday he says revealed “more of a sprain” in an elbow ligament than had previously been believed (via Mark Zuckerman of MASNsports.com and Jesse Dougherty of the Washington Post).

Ross will head for further testing before deciding on his next steps, but it seems likely he will at least be recalled from his rehab stint. It is not clear whether surgery is on the table on this time, but it is obviously an unfortunate development in light of his injury history. Ross underwent a Tommy John procedure in July 2017, and the recovery cost him almost all of the following season. He worked primarily out of the bullpen in 2019, then opted out of the 2020 season over COVID-19 concerns.

The former first-round pick returned to the rotation last year. He worked to a 4.17 ERA with solid strikeout and walk numbers through 108 innings before his season was cut short. Ross was diagnosed with a partial tear of the UCL in his elbow last August, and while he avoided another Tommy John procedure, he was shut down for the remainder of the season. He underwent surgery to remove bone chips from his elbow this spring and has been on the injured list all year.

Last season’s innings tally narrowly mark a career-high. The 29-year-old has been in the big leagues since 2015, but injuries have never allowed him to assume a typical starter’s workload over a six-month stretch. This season was never going to afford Ross that possibility after he started the year on the IL, but it now remains to be seen whether he is in for another extended absence.

It is an important year for Ross personally, as he is on track for free agency this winter. He and the Nationals agreed to a $2.4M salary to avoid arbitration, and he will hit the open market for the first time in his career a few months from now.

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