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Kalininia started in tremendous fashion as she broke Rybakina after several deuce rallies.
But the Kazakh started to show her quality and hit back with a break of her own in the sixth game before breaking again in the 10th game to claim the opening set.
Rybakina started the second set with a convincing hold as Kalininia took a seat to speak to her doctor and after a very swift consultation, the players shook hands to give the 2022 Wimbledon champion her biggest title on clay which will also see her climb to fourth in the WTA rankings.
It was the second time in the tournament that Rybakina had won after her opponent retired after Iga Swiatek was forced to retire in the quarter-finals.
After victory, Rybakina said courtside: “I want to wish Kalininia a speedy recovery because she is a really good friend of mine and I am really happy for all of her results. She did a good job and hopefully can recover for the French Open.
“A big thanks to the crowd and everyone who stayed and watched till the end. It was not easy for us but not easy for you with all the rain today so thank you so much for the support.”
Kalininia said: “I’m really sorry I couldn’t play. I was trying to do my best but of course this is sport and I want to congratulate Elena for not only this title but everything you have done this year starting from Wimbledon, it’s really inspiring and hopefully I can get to your level one day. Best of luck for the season, stay healthy and reach your goals.”