Gymnasts like Simone Biles know what the slightest mental lapse can do.

Before Elena Mukhina broke her neck doing the Thomas salto, a skill so dangerous it is now banned, she told her coach she was going to break her neck doing the Thomas salto.

But her coach responded dismissively that people like her did not break their necks, and Mukhina, a 20-year-old Soviet gymnast, didn’t feel she could refuse. Besides, she recalled later in an interview with the Russian magazine Ogoniok, she knew what the public expected of her as the anointed star of the coming Olympic Games.

“I really wanted to justify the trust put in me and be a heroine,” she said.

Less than a month before the 1980 Olympics in Moscow, Mukhina under-rotated the Thomas salto and landed on her chin. She was permanently paralyzed and died in 2006, at the age of 46, from complications of quadriplegia. After her injury, she told Ogoniok, fans wrote to her asking when she would compete again.

“The fans had been trained to believe in athletes’ heroism — athletes with fractures return to the soccer field and those with concussions return to the ice rink,” she said. “Why?”

The history of women’s gymnastics is strewn with the bodies of athletes like Mukhina, who sustained life-altering or life-ending injuries after being pressured to attempt skills they knew they couldn’t do safely or to compete when they didn’t feel up to it. On Tuesday, withdrawing from the Olympic team final after losing her bearings in the middle of a vault and barely landing on her feet, Simone Biles effectively said that she refused to be one more.

Biles did not mention Mukhina. Nor did she mention Julissa Gomez, the 15-year-old American gymnast who was paralyzed shortly before the 1988 Olympics — and died three years later — as a result of a vault that she had never been able to perform reliably, but that her coaches had told her she had to do if she wanted to be competitive. Biles did not have to mention Mukhina or Gomez. Their stories are infamous in the gymnastics world.

Gymnastics is inherently dangerous, and gymnasts can be seriously injured even when they feel mentally strong. Adriana Duffy, a former Puerto Rican national champion, was paralyzed while training on vault in 1989. The Chinese gymnast Sang Lan sustained a similar injury on vault in 1998 when her coach tried to adjust the position of the springboard as she ran toward it. Melanie Coleman, a collegiate gymnast in Connecticut, died from a spinal cord injury in 2019 after her hands slipped off the uneven bars during practice.

Gymnasts accept that risk every day, but they also know what can increase the risk beyond a level they are comfortable with. And yet, until recently, it had been extremely rare for any high-level gymnast to refuse to compete under those circumstances.

After Biles withdrew, some critics compared her unfavorably to Kerri Strug, who — the popular narrative goes — secured the team gold medal for the United States at the 1996 Olympics by vaulting on an injured ankle. The suggestion was that Biles ought to have done the same for the team.

But Strug performed that vault under pressure from her coach, it injured her ankle further, and the U.S. would have won without it. In an interview with The Los Angeles Times shortly afterward, she said that if she had known her vault wasn’t necessary, she wouldn’t have done it.

“Everybody was yelling at me, ‘Come on, you can do it!’” she said. “But I’m out there saying to myself: ‘My leg, my leg. You don’t understand. Something’s really wrong here.’”

Strug, who never competed again, tweeted a message of support for Biles on Tuesday.

One of her teammates on the 1996 Olympic squad, Dominique Moceanu — who has been outspoken about the training practices used by the former national team coordinators Bela and Marta Karolyi — tweeted a video clip from her own routine in the balance beam final in those Games.

Moceanu’s foot slipped as she landed one flip and took off into another, and she crashed headfirst onto the beam. She clung to it, pulled herself up and continued her routine, then competed in the floor exercise final almost immediately afterward with no spinal examination. It did not occur to her to do otherwise.

Biles’s decision, Moceanu tweeted, “demonstrates that we have a say in our own health — ‘a say’ I NEVER felt I had as an Olympian.”