ATLANTA -- Atlanta right-hander Dan Winkler broke his elbow while throwing a pitch in a 12-7 loss to St. Louis on Sunday.
The defeat left the Braves (0-5) as the only NL team without a win.
Winkler fell to the ground before he could reach the Braves' dugout and said he was thinking, "Not now. Not again."
After missing most of the past season while recovering from Tommy John surgery, Winkler threw a pitch behind Randal Grichuk in the seventh inning Sunday and immediately left the mound, holding his right arm to his chest.
Winkler went down to his knees after crossing the first base line in front of the Braves' dugout and was then assisted to the bench.
Winkler said he "kind of felt something in my elbow" when throwing a slider but "didn't really think much of it" until he was hurt on his next pitch.
"I heard a crack," he said. "I knew exactly what it was right when it happened. It didn't feel good."
Brandon Moss and Matt Carpenter hit three-run homers for the Cardinals. Drew Stubbs hit a three-run homer for Atlanta, and Nick Markakis drove in two runs with three doubles.
The Cardinals completed a three-game sweep despite a poor start from Adam Wainwright, who allowed five runs in five innings.
After rallying for a 7-6 lead in the eighth, the Cardinals put the game away with five runs in the ninth to score 12 runs for the second straight day. Aledmys Diaz hit a two-run double off Jose Ramirez in the ninth before Carpenter's three-run homer.
The Braves' previous 0-5 start came in 1988, when they lost their first 10 games.
Winkler spent most of the 2015 season on the disabled list after elbow surgery in July 2014. He said he hopes the ligament repaired in his 2014 surgery is still intact. He is out indefinitely.
"It's definitely a tough blow for us," Braves first baseman Freddie Freeman said.
Winkler made his major league debut late last season and allowed two runs in 1 2/3 innings.
The loss of Winkler adds to Atlanta's early bullpen woes. The team sent right-hander John Gant to Triple-A Gwinnett on Sunday and recalled right-hander Chris Withrow.
Trailing 6-5, the Cardinals scored two runs in the eighth against Jim Johnson (0-1). Jeremy Hazelbaker and Stephen Piscotty had run-scoring singles to give the Cardinals the lead.
St. Louis right-handed reliever Seung Hwan Oh (1-0) had two strikeouts in a scoreless seventh.
Williams Perez gave up four runs in 4 2/3 innings for Atlanta.