Simone Biles, who just made the 2024 Olympic roster for team USA, is looking back at her performance at the 2021 Tokyo Summer Olympics and the toll it took on her.

Just before she took to the vault at the 2021 Olympics, Biles says she was “fighting demons.” When the Olympic gold medalist and world champion was warming up, she could tell something was off.

During an April episode of the podcast “Call Her Daddy” with Alex Cooper, Biles shared the timeline during which she realized she had the twisties, the phenomenon that led her to withdraw from the team final and women’s all-around at the 2021 Olympics to prioritize her mental health. Biles goes on to discuss her mindset and fears, and answered the question that was on many Americans’ minds three years ago: What are the twisties?

“As soon as I landed (my vault), I was like, ‘Oh, America hates me,’” said Biles. “The world is going to hate me. And I can only see what they’re saying on Twitter right now.’ That was my first thought.”

The last Summer Olympics weren’t the first time she’s dealt the twisties, but having them come about on a world stage brought additional pressure. Ahead, read what Biles has said about her experience with the twisties, whether it’s possible to recover and where Biles stands now ahead of the 2024 Olympic Games.

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.”

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. In the air, she was unsteady. “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 the podcast. “I felt like I was fighting my body and my mind to do these tricks.” She knew she had the twisties but tried to “push past that.”

When the time came to perform the move for the competition, the feeling hadn’t passed. 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. The highest score for this move is 15.8, according to NBC News. Biles’ score was 13.766. During qualifications, she’d scored 15.183.

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.”

Biles said on the podcast that the twisties are like if you were suddenly unable to control a car that 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 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.

Why do the twisties happen?

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. 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.

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.

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 and she just qualified for the 2024 Olympic Games at the trials held at the end of June.

During an interview with TODAY’s Hoda Kotb who was present when team USA was announced June 30, 2024, Biles said this year’s games were going to be a redemption tour. “In Tokyo, we all didn’t have our best performances, so we’re excited to go out there, and especially Hesley (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 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.

But that’s not to say the twisties won’t make a return. Biles also experienced the twisties ahead of the 2016 Olympic Games in Rio, according to Olympics.com.

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