Simone Biles Pulls Out of the Olympics!

And my very humble take on it


Dr. Nidhi Shah PT, DPT, MS

The country’s most decorated gymnast since 1992, Simone Biles made the decision on July 27 to pull out of the 2021 Tokyo Olympics gymnastics team final, citing a “mental issue” after a disastrous vault on the previous day. Some people applauded the 24-year-old for being forthcoming about her mental health and taking care of herself during an extremely stressful time. Meanwhile, there are others who called the young gymnast a “selfish sociopath” for choosing her own health over another potential win for Team U.S.A.

While it is not for me to make commentary on the decision that was made and how it affected the country (congrats to the rest of the team on bagging that SILVER medal!!), I am here to SPECULATE (just speculating as an expert who works exclusively on brain-body connections) the reason this happened.

During a press conference after the event, Biles revealed that she was suffering from the “twisties”, described by the press as a mental condition that occurs when the body and the mind become disconnected, posing a danger to the athlete. She posted a video to her Instagram story that was deleted shortly afterwards, she revealed that “sometimes I can’t even fathom twisting, I seriously cannot comprehend how to twist”.

While I was watching her moves, and her fateful midway stop on her planned 2.5 twist vault, I was terrified! I am not a gymnast but I deal with head movements, body movements and physics all day.

She could have been severely injured when she ended up doing something different than was planned. Up in the air like that, generating the body forces to perform a twist and being unable to complete it could have caused her to land on another body part (e.g. her head) and caused a bad injury.

What it could have also caused is a coup/countercoup force in her skull OR labyrinth (the small bony canal that holds the inner ear – vestibular system). Smaller forces have caused concussions/labyrinthine concussions in clients I see (of course, they are not athletes who undergo rigorous training like Biles does). This is only speculation as I stated above.

Another theory that comes to my mind is that she suffers from/developed BPPV, a displacement of small (really, really small) calcium carbonate crystals from their home in the utricle into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be.  This could cause a false perception of movement in one’s head when there is none, which could be labeled easily as “twisties”.

All of this dizziness, shakiness and a lack of control over the body-mind connection could cause mental health issues in an athlete who is training so hard and representing her country at the Olympics. So, I don’t believe her mental health claims are untrue.

What is also true is that by claiming mental health issues, she could retain her slots in event finals if she were prepared to compete and chose to do so at that point. On the contrary, if the camp admitted medical issues such as concussion or a vestibular lesion, she would be out of all the other events as per competition rules.

However, l do wonder and hope she receives (or is receiving) care from a vestibular therapist who will help her get back into the game for the next Olympics.

All rights reserved.

Your Movement Specialist.

2 thoughts on “Simone Biles Pulls Out of the Olympics!”

  1. Very insightful. Gymnasts appear so graceful and the sport so gentle. But your article shows how it can become dreadful for athletes even if slightest of mishaps may take place. Experienced therapists as youself are a necessity to keep them in good shape!

    1. Thank you for your kind comment. There is a desperate need to educate the masses about the availability of services such as Vestibular Rehab. I have seen clients who have suffered for years before finding resolution with us.

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