On October 11, 2006, he signed a five-year $24.7 million contract extension with the Rams. The 2006 season saw him play in 11 games after breaking his hand versus the Chicago Bears on December 11. He finished the campaign with 36 tackles and two sacks. In 2007, he recorded 40 tackles and two interceptions in 9 games. Hand, knee, shoulder, elbow, and ankle injuries struck in ‘06 and ‘07, forcing Tinoisamoa to miss 12 of 32 games. But he stayed healthy the following season, playing all 16 games and led the team in tackles.