Editorial illustration of Simone Biles mid-air in her competition leotard with the KneeEd wordmark and a coral and blue motion glow tracing her rotation.

Simone Biles: No Idea Which Way Was Up

The twisties are not a nerve failure or a confidence problem. They are the brain pulling the emergency brake. A closer look at the science, the roughly two-year recovery nobody could schedule, and why physical health is mental health.

KneeEd editorialUpdated June 7, 202614 min read

On July 28, 2021, during a vault warm-up at the Tokyo Olympics, Simone Biles left the table for a Yurchenko double pike, a skill she had landed thousands of times, and her brain lost track of where her body was. She came down on her back instead of her feet. Moments later she withdrew from the team final, and then from all four individual finals: all-around, vault, beam, and floor. She had not torn a ligament. She had not failed a test. What had failed was something most people never have to think about, the brain's real-time sense of itself in space.

Literally cannot tell up from down. It's the craziest feeling ever. Not having an inch of control over your body. What's even scarier is since I have no idea where I am in the air I also have NO idea how I'm going to land, or what I'm going to land on.
Simone Biles, July 2021

Gymnasts call it the twisties. The name is almost too small for what it is. It is not nerves and it is not a confidence dip you can will your way through. It is a genuine breakdown in the brain's motor control, the same circuitry that lets you touch your nose with your eyes closed, scaled up to a body rotating at speed several feet off the ground. The recovery that followed had no clean clinical label and no schedule. It ran about 22 months, and it changed how elite sport talks about the line between mental and physical health.

The recovery that nobody could schedule

Start with what the recovery actually was, because the popular version gets it backward. The story is usually told as if Biles took some time off, got her head right, and came back. That is not what happened. What happened was a long, structured, professionally supported program of rebuilding two systems at once, the psychological and the physical, because in her case they were never two separate things. The work was led by her coaches, the married coaching team Cecile and Laurent Landi, who had guided her since 2017, and it was anchored by weekly therapy that did not pause when the cameras left.

She did not rush a return to the apparatus. For most of 2022 she stepped back from intensive training entirely. A graduated return began around September 2022, roughly fourteen months of minimal training before she was even building toward real volume. Two-a-day sessions resumed in January 2023. Only after her April 2023 wedding did she commit to full-force preparation. The August 2023 competition return came at the end of a deliberate, phased ramp, not at the front of a comeback narrative.

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