Carlos Zambrano had an extra day of rest after his 136-pitch outing against Philadelphia last Saturday.
Then Zambrano got a few more hours of rest Saturday night when the Cubs' game against the Washington Nationals was delayed 2 hours 40 minutes by rain.
But after three perfect innings, Zambrano (3-2) fell apart in the Nationals' four-run fourth before leaving with pain in his right elbow.
The Cubs went on to lose 4-3 before 42,829 at RFK Stadium, watching their three-game win streak get snapped by right-hander Livan Hernandez.
Corey Patterson's RBI single off closer Chad Cordero in the ninth brought the Cubs to within one run before Neifi Perez flied to left and Derrek Lee popped to second to end it.
Trainer Mark O'Neal said Zambrano felt pain in the fourth inning below and above the elbow joint on the low end of the biceps. He compared it to tennis elbow.
"We're going to watch it and treat it as something you want to watch," O'Neal said.
Manager Dusty Baker said he didn't know if Zambrano would make his next start.
"He didn't feel it in the last game or pitching on the side," Baker said.
Zambrano was examined by a Nationals doctor at the ballpark. The Cubs are likely to order an MRI on Zambrano's elbow Sunday.
Zambrano left the clubhouse without speaking to the media.
Zambrano said last week he's not worried about incurring an arm injury down the road, and has told Baker he'd gladly throw 140 pitches if that's what it takes. Baker said before Saturday's game he'd monitor Zambrano's pitch count closely.
"I don't think we've ever taken him that far," Baker said, referring to Zambrano's 136-pitch effort in a 2-1, complete-game win. "We'll see how he's throwing, look at his velocity, see if he labors at all, or if his arm tires any quicker or whatever."
The matchup of Zambrano against Hernandez pitted two of the National League's most durable starters. Hernandez led all NL pitchers with an average of 112.9 pitches per start, while Zambrano was second at 111.4. But both left with injuries Hernandez (6-2) incurring right knee inflammation in the seventh inning.
Zambrano was economical with his pitches over the first three innings, retiring the side in order on 10, 16 and nine pitches, respectively. But he labored through the fourth, hitting two batters, giving up three run-scoring singles and throwing 29 pitches before leaving with one out and the bases loaded, trailing 4-1.
A poor decision by Zambrano on a sacrifice attempt by Jamey Carroll paved the way for the game-turning inning. With a runner on second and no outs, Zambrano tried to make a play at third, but his off-balance throw was late, leaving runners on the corners.
After loading the bases by hitting Nick Johnson with one out, he gave up a two-run single to Vinny Castilla and an RBI single on the next pitch to Ryan Church.
Zambrano then plunked Brian Schneider and gave up an RBI single to Cristian Guzman before leaving. Jose Macias' pinch RBI single sliced the Nationals lead to 4-2 in the fifth.
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