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The issues led the 25-year-old to have dips with his velocity as he allowed a career-high seven earned runs before exiting alongside a team trainer because of “fatigue-related issues.”

Liberatore lasted four-plus innings in the Cardinals' 7-5 loss to the Royals in Game 2 of a doubleheader at Busch Stadium. Along with the season-high seven runs allowed, Liberatore matched a season high in hits allowed with eight. The outing left his ERA at 3.82.

“Over the course of the season, you're going to have times where you feel synced up and kind of lose the feel for it and find it again. I just didn't find it again tonight,” Liberatore said.

While Cardinals manager Oliver Marmol said his concern with the fatigue Liberatore dealt with was “not high,” Liberatore said he “wasn’t concerned” with any health-related issues. Liberatore said the mechanical issues he worked through make it difficult to maintain velocity and leads to a quicker feeling of fatigue. The lefty did not undergo imaging, but he went through “standard” testing with the team’s medical staff.

Before he began the fifth inning, Liberatore said he told the Cardinals coaching staff that “nothing hurts.”

With the Cardinals (34-28) and Royals tied 5-5, Liberatore’s fastball velocity dipped to a low of 89.5 mph when he faced Maikel Garcia. Liberatore’s average fastball velocity (93.9 mph) was a half mile per hour lower than what it has averaged this season. He experienced a 1.6 mph drop in his average cutter velocity compared to his season average and had dips in the average velocity on all six pitches he flashed against Kansas City, per Statcast.

The drop in Liberatore’s fastball during the fifth inning prompted Marmol and a team trainer to visit Liberatore. Liberatore was lifted from his start after 71 pitches following the visit.

"In talking to him (Liberatore), he said he felt really good. Even when we took him out, he said he felt good. Just out of sync with his mechanics," Marmol said.

Liberatore allowed two runs in his first inning and three runs in the third inning, which put the Cardinals in a 5-1 deficit. Before the Royals reclaimed their lead with runs in the fourth and fifth innings, the Cardinals tied the game with two runs on a double from Willson Contreras and another two on a homer from Nolan Arenado.

Liberatore allowed two homers and three doubles in the start. Four of the eight hits he gave up had exit velocities above 105 mph. Two of those were hit above 110 mph, per Statcast.

“He (Liberatore) doesn't have his main stuff,” Marmol said. “It was a little easier to hit, but with the doubleheader, you try to stick with him as long as possible, especially if... nothing is wrong. It's just not coming out the way he wanted to. That was the main thing.”

Marmol said Liberatore will continue to be monitored on Friday. The Cardinals feel Liberatore’s drops in velocity and fatigue are not linked to a serious injury.

Coming off an outing that was his shortest of the season not influenced by weather and one that marked his second consecutive outing with four or more earned runs allowed, Liberatore noted the Thursday start left him with moments he could learn from as he puts a focus on fixing the mechanical issues that plagued him in the coming days.

“I'm not concerned about it. I don't think anybody else is overly concerned about it” Liberatore said. “It's just a matter of finding it again and being able to stay consistent with it.”

Before their offense was slowed by Royals relievers Angel Zerpa and Steven Cruz, both of whom completed three scoreless innings in Game 2 to relieve starter Cole Ragans, the Cardinals found success against Kansas City’s bullpen on Thursday afternoon. That effort to complete a comeback in Game 1 was capitalized on a clutch hit from Contreras in the 10th inning.

Playing in the 1,000th game of his major-league career, Contreras lined a single to left field in the 10th inning of Game 1 that scored Lars Nootbaar from second base to seal a 6-5 win in a game the Cardinals trailed 3-0 through six innings.

Contreras jump-started the Cardinals offense in the seventh inning by hitting a leadoff double that had a 113 mph exit velocity vs. John Schreiber.

When Game 1 reached the 10th inning following a two-run homer from Herrera and a blown save by closer Ryan Helsley, a ground out from Masyn Winn pulled the Cardinals into a 5-5 tie. An intentional walk to Brendan Donovan with first base open put Contreras in a position to put an exclamation point on his 1,000th game in the major leagues.

“I was waiting for it,” Contreras said of the intentional walk. “I was watching the game... I'll say that the game the dictates that he was going to walk Donovan, but that fired me up. It's not an insult because it's part of the game, but it's kind of like, ‘I want you to roll over for a double play.’ I was like, 'Eh, not me.' I'm glad that I was looking for some pitch right down the middle, and I got one of those.”