World number five Elina Svitolina said she could miss Wimbledon with a heel injury, after slumping to a second-round defeat by qualifier Camila Giorgi in Birmingham on Thursday.

The 22-year-old Ukrainian was clearly struggling as she slid to a 6-4, 4-6, 6-2 loss to a player ranked outside the top 100 at the Wimbledon warm-up event. Afterwards she suggested she would consider pulling out of the third Grand Slam tournament of the year, which starts on July 3.

“There is a question about it,” she admitted. “I will talk with my physios. The season is very long and I must look at the bigger picture. The heel feels painful and is very sensitive. I am disappointed I am out of the tournament but I am not disappointed with my performance, because I could not show even 50 percent. Also the court was slippery which is bad for the foot.”

The lush grass in the English midlands is utterly different to the clay on which Svitolina won the Italian Open and reached the French Open quarter-finals, where she missed a match point against eventual runner-up Simona Halep.

Combined with a sudden change from Wednesday’s fierce heat to drizzle and damp, it became hard for the stricken Svitolina to cope. Giorgi adapted to the slick surface very well, hitting some raging forehand drives, finding some good angles, and occasionally coming to the net effectively. The Italian played close to the standard that two years ago took her to 30 in the world.

With Dominika Cibulkova having already lost in the first round, the two leading seeds have both departed early, following belated withdrawals from four other top-10 players. Svitolina often played well in the second set and broke serve to lead early in the third, but her standards dropped away.

“I am not surprised about the way Giorgi played because she always played great on grass,” she said. Giorgi now has an enticing opportunity to enhance that reputation, as she will have a quarter-final against another surprise survivor, Ashleigh Barty, a 21-year-old Australian making her first appearance in the main draw.

On Wednesday she overcame Barbora Strycova, the eighth-seeded Czech, who is a two-time former finalist.