'Twisties': The Mental Block That Affected Simone Biles

In July 2021, Simone Biles pulled out of the women's all-around final in gymnastics at the 2020 Summer Olympics (which took place in 2021) to "focus on her mental health," confirmed USA Gymnastics in a statement.

The news came after Biles withdrew from the women's team final, where Biles completed one vault before telling her teammates she wouldn't be competing for the rest of the team competition. At that time, USA Gymnastics said in a statement that Biles had withdrawn "due to a medical issue."

Hours later, in an interview with TODAY, Biles revealed that the medical issue was not a physical one, saying, "Physically, I'm good, I'm in shape. Emotionally, that kind of varies on the time and the moment."

Later, Biles offered more clarity about what might have been behind her decision to pull out of the team final and the individual all-around. 

"[My teammates] saw it a little bit in practice... having a little bit of the twisties," Biles told the press.

So, what exactly are "the twisties" that Biles referred to? And why would a gymnast potentially need to pull out of competition for them? Here's how three sports psychologists explained the phenomenon.

What Are the Twisties?

The twisties is an informal term used to refer to a certain kind of mental block that a gymnast can experience as they are in the air during a twisting skill.

When you get the twisties, there is a disconnect between the brain and body, Jamie Shapiro, PhD, a certified mental performance consultant and co-director of the sport and performance psychology master's program at the University of Denver, told Health. 

"The body knows what to do, and motor programs are stored in the brain, but the brain is having trouble accessing those motor programs," explained Shapiro.

The twisties can cause you to lose your sense of where you are in the air. That brain-body disconnect makes you feel "a loss of a sense of control over the movement," added Shapiro, a former club and collegiate gymnast. 

The twisties can have physical and mental implications. Physically, the twisties can make you unable to perform skills as you previously could. Mentally, that inability to perform those skills can cause anxiety, exacerbating the mental block.

What Causes the Twisties?

"Gymnasts have a wonderful inner sense," Allie Wagener, PhD, a licensed psychologist specializing in sport and performance psychology at Achieve Performance Psychology, told Health. 

That sense is scientifically known as proprioception, or the body's ability to sense its movement and position in space. Proprioception lets you know where you are relative to the ground as you twist through the air. That awareness lets you know when and where you will land, preventing you from falling or landing in the wrong position.

"But what happens when the twisties come is you kind of lose your sense in the air. You kind of lose where you are, and you almost become disoriented," explained Wagener, a former gymnast. "It's super scary. It can be terrifying because if you don't know where you are in the air, you don't know how to land, and that's what can be pretty dangerous for injuries."

And after experiencing the twisties, as you go for your next attempt, you may worry about the feeling happening again. You may come out of a skill too early or not attempt it at all, said Shapiro, both of which can jeopardize your safety. For example, a gymnast experiencing the twisties may run past the vault rather than push off the springboard.

Physical and Mental Causes of the Twisties

"Usually, it starts with fear of failure and not wanting to disappoint others or extremely high expectations that the athlete internalizes," Patrick J. Cohn, PhD, a mental training expert, and president and founder of Peak Performance Sports, told Health. There are mental or physical causes of the twisties.

Some of the mental causes of the twisties include stress or anxiety, which may cause racing, negative, or distracting thoughts. According to one article published in 2022 in Heliyon, too much stress can cause athletes to make mistakes.

One of the physical causes of the twisties is focal dystonia, a neurological condition involving involuntary muscle spasms in one area of the body. Or, frequently, the twisties can happen "out of the blue," added Shapiro said. You can go into a skill, and then, for whatever reason, you feel off in the air.

How Long Do the Twisties Last?

The twisties can be something that happens just during one or two attempts. Or the phenomenon can happen one day, and the next day, you have your in-air sense back. Or the twisties can last for months, explained Wagener. Because everyone's experience with the twisties is different, there is no standard for how long it takes to overcome. 

"It could take days, weeks, years, or someone might never get over it," said Shapiro. "[The twisties] can be career-ending for an athlete."

In most cases, though, gymnasts overcome the twisties, said Cohn. According to Cohn, overcoming the twisties typically takes two to four months.

How To Overcome the Twisties

You can use different techniques to overcome their twisties, though what works can vary from person to person. Some of those techniques include:

• Visualization: Picture what the skill should look like.
• Progression: Start with a basic skill. Then, gradually work your way to a difficult skill while reminding your body where you are in the air can help build your confidence. Let's say you experience twisties with a double twist. With progression, you start with a half twist, then do a full twist, then a twist and a half, eventually building your way up to the goal of a double twist.
• Focusing on a different skill: This involves focusing on a skill you're confident with rather than forcing yourself to attempt the skill tied to your twisties. "You can just take a break from it, go work on something else, and then maybe return to it," explained Wagener. "Sometimes you need to take that stress and pressure away from it."
• Watching videos: It may help to watch footage of yourself doing the skills and making the moves while watching the videos. You can see and feel yourself go through the movement.
• Developing simple cue words: Say these to yourself during the routine to stay focused on the skill rather than the fear and other distractions.
• Talking to someone: Speaking with a mental health professional or a sports psychologist may help with stress or anxiety.

"One thing that I usually advise parents and coaches to do is give the athlete a break and don't ask about it. The athlete is already anxious, and asking about it or pushing it too soon can exacerbate the mental block due to increased pressure and stress," said Shapiro. "Sometimes, the athlete needs a break from the skill or the sport."

Who Else Gets the Twisties?

The twisties don't only affect gymnasts. An athlete playing any sport that involves twisting, flipping, or rotating—really, any time you need to spot where you're going to land—can develop the twisties. Even musicians and stage performers can develop their version of the mental block.

"It is most commonly referred to as the 'yips' in golf and baseball, where athletes suddenly can't putt or throw the ball where they want to," explained Shapiro. "Musicians may also experience the 'yips' where they can't play a piece they were previously able to perform. There is also 'stage fright' for performing artists, which could be quite debilitating."

Training Your Mind and Your Body

Biles sharing her experience with the twisties is a good reminder that even professional athletes are humans "just like you and I," said Wagener. 

"Creating a safe and inclusive and supporting environment for these athletes to do their craft" is important, added Wagener. "It's OK to have an off day. It's OK to have a bad day, especially in a sport where you're judged on perfection."

Also, remember that training your mind is just as important as training your body. 

"These athletes tend to train their bodies so hard through practices, through specialized coaches. And I think sometimes having that training for your mind is just as important but often gets missed," said Wagener.

"And even when you are trained mentally and physically, we can still have things that disconnect and have off days, and that's really normal," continued Wagener. "You can be the most mentally resilient, strong person and still have an off day. And I think normalizing that, especially among elite athletes, is really important."

A Quick Review

The twisties is a mental block that a gymnast can experience as they are in the air during a twisting skill, which affected Biles at the 2020 Summer Olympics. Additionally, golfers and musicians can experience a version of the twisties called the yips.

If you experience the twisties or yips, addressing any stress and anxiety affecting your physical performance is essential. Training your mind can be just as important as training your body.