Explained | How did U.S. athlete Simone Biles overcome the disorientation and stage a comeback?

The story so far: Simone Biles was seemingly adept at defying gravity and always blended aesthetics with accuracy. But something was amiss and it became evident when the acclaimed gymnast from the U.S. withdrew from the floor final at the Tokyo Olympics. Attention was immediately drawn to mental health, a grim theme coursing through the sporting world, and Biles joined the aggrieved ranks of tennis star Naomi Osaka and cricketer Ben Stokes.

What made Biles withdraw from several of her events?

Deep within Biles was battling depression and she knew that her mind and limbs were not in sync. Gymnasts flip mid-air and are expected to land like a cat while maintaining a peacock’s graceful vibe. But if the mind is at sea, a life can be in peril. The 24-year-old Biles was performing a vault when she appeared disoriented and stumbled as she landed. India got familiar with the Produnova vault which Dipa Karmakar pulled off at the Rio de Janeiro Games in 2016. But it has another name: the vault of death.

What are ‘twisties’ and why is it considered dangerous?

Sport is about skill, athleticism, muscle-memory and balance. The last two attributes have greater significance in gymnastics as its purveyors often levitate without a smidgeon of a doubt. Later Biles said: “It’s honestly petrifying trying to do a skill but not having your mind and body in sync.” She was trying to explain ‘twisties’, a condition in which the concerned athlete is up in the air and inexplicably has no idea where the ground is nor about how or where to land. It is like an aeroplane’s ‘Mayday’ distress call, and triggers doom.

What makes the athlete feel that he or she is diving into a pool without water?

When the ‘twisties’ strike, the imbalanced athlete can lose the reflexive attribute of seeking the floor. While diving into a swimming pool, the water breaks the fall and its tactile stimulation and the resultant reflexive swimming ensures that the diver is safe. But imagine if the pool is devoid of water, the athlete then has to pirouette in time and land well, else the risk of fractures and a spinal injury quadruples. Gymnasts are expected to deal with this quandary in their profession.

What role does the brain play in executing skills and maintaining balance?

According to Kathleen Cullen, a professor of biomedical engineering at the Johns Hopkins University School of Medicine, who spoke to livescience.com, “the brain draws sensory information from the eyes — proprioceptive nerve cells pass on information about the body position — and the vestibular system, the sensory system in the inner ear, which controls balance.” When something goes askew, vertigo strikes and the person feels that the world is spinning. The ‘twisties’ is another variant. Experts mention that gymnasts, through practice, condition their brains to accept their unique movements. The brain and the limbs are on autopilot but when athletes are dealing with stress or, worse, depression, they become acutely conscious and in trying to over-think their physical responses to external stimuli, it unhinges the synergy between the brain and the limbs.

How can an athlete regain balance and confidence?

The first step is to admit there is a problem, and Biles did that. A break from sport and sustained counselling is mandatory and once the athlete has shed the mind’s cobwebs, repetitive practice with foam cushions in place on the floor, just in case the ‘twisties’ strike, should help in sharpening muscle-memory. Biles did come back to compete in the beam final and won a bronze on Tuesday.