Williams, a two-time Cincinnati champion, had retired during the Rogers Cup final Sunday in Toronto against Bianca Andreescu with the same injury.
Andreescu becomes leading 3-1 in the first set, and, despite the fact that down ruin of provider, Williams nonetheless had each chance of rescuing the set and the suit, but opted to throw the towel in, and surpassed the Canadian victory.
Saturday's win was Andreescu's first match this week that did not go three sets. She's had a tough year with injury and she was pretty taped up during the Rogers Cup, and did take a medical timeout.
"I just knew", said Williams, adding she'd undergone hours of treatment before the match to combat the back spasms she'd first felt in a semi-final win on Saturday night.
Williams's retirement was the last in a string of high-profile injuries at this year's Rogers Cup. "I didn't want to pay attention to that".
Serena, nearly 39 years old, mentioned in a statement that she stood poised to play and hope was still looming on Tuesday morning, but she finally disillusioned as her back remained not right.
When Andreescu took the podium to accept the championship trophy, she noted the unorthodox ending to the competition and her deep admiration for her opponent.
Nevertheless, she wanted to give it a go in the final.
With big aspirations in mind, Andreescu has worked hard over this past season, and her meteoric rise hasn't come easy. Although Andreescu argued with the umpire on the next point when a shot was out, she still returned the shot and got a point to make it 6-4 on the tiebreak.
Williams, twice champion of the Cincinnati Masters, was looking to use the tournament to fine-tune ahead of the US Open, which starts on August 26.
"Now with this win, especially after coming back from being two months off, I think it's really giving me confidence to do really well in the U.S. Open".
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