Team trainers and manager Tony La Russa attended to Pineiro the pitch before when he appeared to have a cramp in his left arm. After head athletic trainer Barry Weinberg massaged his left arm near the elbow, Pineiro remained in the game. But after his next pitch, a 2-2 fastball that Anderson swung and missed at to end the inning, Pineiro fell to the ground and began grabbing his right leg in what appeared to be another cramp.
Catcher Yadier Molina and first baseman Chris Duncan carried Pineiro from the field and lefty Trever Miller came in to start the eighth inning.
After giving up four runs -- only one of which was earned -- and four hits in the first inning, Pineiro retired 16 Tigers in a row before a leadoff single in the seventh by Brandon Inge ended the streak. But he recorded two flyouts and the strikeout of Anderson to end the seventh.
Pineiro threw just 83 pitches and probably would have headed back out for the eighth if not for his injury.
B.J. Rains is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.