Cincinnati Reds right-hander Johnny Cueto left with strained right triceps in the fifth inning of Saturday night's game against the Pittsburgh Pirates.
After striking out Pedro Alvarez to start the inning, Cueto threw a first-pitch strike to Travis Snider then began shaking his right arm. A Reds trainer visited Cueto on the mound, briefly massaged his upper arm and both then walked to the dugout.
Cueto won 19 games last season in helping Cincinnati in the National League Central title. However, he left the first game of the NL division series against San Francisco with an oblique strain that knocked him out for the rest of the series, which the Giants won in five games.
Cueto allowed only one run and two hits in 4 1-3 innings with one walk and three strikeouts.
Alfredo Simon relieved Cueto with the score tied 1-1.