Despite struggling with the twisties at her last Olympics appearance, Simone Biles has officially become the most decorated American Olympic gymnast. She led Team USA's women's gymnastics to win the gold in the team finals, she one gold at the all-around competition, gold at vault finals and on August 5, she secured silver at floor finals.
It is her eleventh Olympic medal, surpassing the record previously held by "Magnificent Seven" Shannon Miller.
Biles was famously absent from multiple events at the 2020 Tokyo Olympics due to a bad case of the twisties. But what are the twisties in gymnastics? And how did she recover?
Here's what to know about the twisties in gymnastics, whether it's possible to cure them, and what Biles has shared about her experience.
What are the twisties?
The twisties happen when a gymnast is in midair and loses their sense of where they and how they’ll land, making the move risky. Biles described it as being "lost in the air."
For example, when Biles was suffering from the twisties in Tokyo, what was meant to be a 2.5 rotation in the air became a 1.5 instead. Biles didn’t think she’d make it all the way around and cut herself short, landing unsteadily, according to NBC News.
Biles has likened the twisties to the yips in golf or baseball, when athletes have involuntary wrist spasms that affect their game, per the Mayo Clinic. But the key difference between the twisties and the yips is that in gymnastics, a miscalculation in midair could mean a potentially catastrophic injury.
What do the twisties feel like?
When practicing her vault ahead of Team USA’s first gymnastics rotation back in 2021, Biles noticed she wasn’t performing as she usually does and felt unsteady in the air.
“It doesn’t feel comfortable, I have no idea where I am, but I’m twisting, praying I land on my feet,” Biles said on an April episode of the podcast “Call Her Daddy” with Alex Cooper. “I felt like I was fighting my body and my mind to do these tricks.”
Biles added that the twisties feel like suddenly being unable to control a car you drive daily. “Your mind and your body are at a disconnect. Your body is going to try to do something, and your mind is going to be like, ‘No, you’re not doing this,’” Biles explained, adding that in her case, she had no airbags and no seatbelt: “I am my car.”
Biles was sure to tell the public that there was nothing physical that caused her to withdraw. “No, no injury, thankfully,” she said at a press conference. “And that’s why I took a step back, because I didn’t want to do something silly out there and get injured.”
What causes the twisties?
Biles said the reason for her twisties was likely stress and other psychological factors.
“(The pressure) feels heavy," she told TODAY’s Hoda Kotb in 2021. "It’s like the weight of the world on your shoulders and I’m very small, so I feel like, at times, it’s very overwhelming, but whenever you get so overwhelmed and have triggers, it’s just like — I have to focus on my mental wellbeing and that’s what I did.”
The twisties are common in the gymnastics world.
Explaining why Biles may have gotten the twisties in 2021, her former teammate Aly Raisman said: “She’s doing such difficult skills, and she can twist so much more than the average person. She’s human. Sometimes it happens when you’re in the air, and we just kind of get confused.”
Aimee Boorman, Biles’ former coach, said that in the 12 years that she coached Biles, she would occasionally suffer from the twisties.
“Every once in a while, she would form this block, and it usually had nothing to do with the gymnastics itself. It had to do with other things going on ... in her universe,” Boorman told Stephanie Gosk in a July 2021 interview on TODAY.
How to cure the twisties
To overcome it, gymnasts will typically minimize the difficulty of a skill and work their way up again, or they’ll keep attempting the move into a foam pit, according to the Olympics website.
Boorman said it could take Biles anywhere from two days to two weeks to recover.
“Normally, when it would happen, we would go back to training, and we would stop doing the skills that were making her feel like she was in the twisties,” Boorman explained.
Are the twisties the same as vertigo?
While both can make you feel dizzy, vertigo is an inner ear issue that causes a spinning sensation, according to the Cleveland Clinic. The twisties, on the other hand, tend to set in for gymnasts when they’re midair and the body can’t seem to figure out what the mind is aiming to do. Vertigo and the twisties are not the same.
Has Simone Biles recovered from the twisties?
Biles has recovered from the twisties and even powered through an injury at the Olympic qualifiers in Paris.
Biles showed out at the 2024 Paris Olympics by taking home four medals — three of which are gold.
In a July 2024 interview with Elle, Biles said she's prioritized her mental health since the last Games. “I am doing therapy weekly to keep everything in tune so that I feel comfortable and confident enough to be competing,” she said. “It’s been a crucial part of my training regimen.”
“I think before I was kind of pushing down my trauma, and now I’ve learned to speak on it and kind of release that,” Biles told TODAY’s Hoda Kotb in July ahead of the Paris Olympics. “I think we used to think of therapy as a weakness, and now I think of it as a strength.”
At the Games, Biles even attended therapy sessions ahead of her competitions. "I saw (my therapist) about three or four times throughout this whole entire process," Biles told Kotb on Aug. 6 after her final competition. "It didn’t matter if it was before all-around or after qualifications, I went back to the village and I got on a call with her and did my therapy sessions, because that’s routine for me."
When Hoda asked Biles what she got from therapy, she said: "It just gave me the confidence," Biles said. She's not willing to give up that sense of comfort and security "just because I'm halfway across the world."
Biles has also taken renewed pride in her appearance, which boosts her morale. “I understand and realize I have to take care of my physical appearance as well as my mental,” she told the outlet. Specifically, giving special attention to her hair ahead of competitions, she went on to say, has given her confidence.
During another interview with Hoda, Biles said the 2024 Olympic Games are going to be a redemption tour for USA gymnastics. "In Tokyo, we all didn’t have our best performances, so we’re excited to go out there, and especially Hezly (Rivera) along the ride, and just go out there and kill it," Biles said.
She went on to mention the challenges she and the team faced at the last games. "There were definitely some things that we had to overcome that day during that meet, and I think we all have a little bit more to give," said Biles.
"I know we’re more mature. I think our gymnastics is better. I think we’re a little bit more confident in what we’re doing, so we’re excited."
As far as the twisties are concerned, Biles has been in good shape for some time. In 2023, she offered an update: “I’m fine. I’m twisting again. No worries. All is good,” Biles said, NBC Connecticut reported.
Biles also experienced the twisties ahead of the 2016 Olympic Games in Rio, according to Olympics.com.
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