The 23-year-old Greek was trailing 4-2 during the first set when
he called the trainer on court before shaking hands with his
opponent to signal his retirement.
Tsitsipas declined to share details of his physical condition
but added that he did not want to aggravate the problem ahead of
the ATP Finals from Nov. 14-21 in Turin, Italy.
"I haven't retired once in my life, and it was something that I
had to do today," he told reporters.
"I'm trying to be precautious for the next tournament, which is
the most important one for me.
"My arm has been -- I have had an issue there for quite a while
now. It has gotten bigger in the last couple of weeks, so I'm
just trying to protect it."
The season-ending ATP Finals is played between the top eight
men's singles players and doubles teams.
Tsitsipas, world number one Novak Djokovic, U.S. Open champion
Daniil Medvedev, Alexander Zverev, Andrey Rublev and Matteo
Berrettini have qualified for the event with two spots yet to be
confirmed.
"I'm going to have treatments. I'm going to try and have the
best people treat me, and give me the best advice. Anything
possible to recover and be 100% again," Tsitsipas said.
One of those still hoping to book a place in Turin, Italian
youngster Jannik Sinner, the eighth seed, was beaten 7-6(1) 7-5
by rising Spanish force Carlos Alcaraz.
Fifth seed Rublev also came unstuck as the Russian lost 7-5
7-6(2) to American Taylor Fritz, while ninth seed Felix Auger-Aliassime
fell 6-3 7-5 to German lucky loser Dominik Koepfer.
Two players still eyeing debuts in the end-of-season showdown
kept themselves in the hunt.
Britain's Cameron Norrie maintained his impressive late-season
form with a 6-3 6-4 victory over American Reilly Opelka.
Carlos Alcaraz's win over Sinner means Poland's Hubert Hurkacz
is up to eighth position in the race to Turin after he beat
American qualifier Tommy Paul in straight sets.
Norway's Casper Ruud, seeded sixth in Paris, holds seventh spot
in the Race standings and will look to strengthen his position
against qualifier Marcos Giron in the round of 16 on Thursday.
Giron upset 11th seed Diego Schwartzman as he edged two
tiebreaks on Wednesday.
Russian second seed Medvedev concluded a busy day with a tight
7-5 6-4 defeat of Ilya Ivashka after Germany's Zverev eased into
the last 16 with a 6-3 7-6(5) win over Serbia's Dusan Lajovic.
(Reporting by Sudipto Ganguly in Mumbai and Martyn Herman in
London; editing by Toby Davis and Ed Osmond)
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