Simone Biles pulled out of the gymnastics events at Tokyo Olympics 2020, leaving her fans shell-shocked by the decision. When she decided to skip the all-around final, USA Gymnastics revealed that she is out due to a medical issue. But the exact reason was not revealed.
Later, Biles revealed that she was experiencing twisties. This mental condition in sports was not a popular term before. Later Biles pulled out of the vault and uneven bars as well as she was unable to come out of twisties.
We try to find out what twisties are and how they are a big hurdle to cross from even for the greatest of athletes, with the help of experts.
First of all, we need to understand what twisties are before explaining what are its causes.
Shikha Kedia Mishra, a leading physiotherapist with the elite India women's boxing team, says twisties are a result of a lack of communication between the brain and body.
Explaining the condition in detail to Firstpost, she said, "What happens when you close your eyes and lift your hand up, can you tell the direction in which your hand is moving? You can. You are not seeing it but you still can make it out, you have that feeling which direction your hand is moving to."
The movement of hands and the sense that in which direction it is moving is told to the brain by two receptors in our body. And the brain further guides the body to do those movements.
"There is something called Proprioception and Kinesthesia. These are some receptors that are present in our body. They are present in the skin, they are present in the joint. They are present in the muscles. So these receptors are very tiny. They have the sense of where our body is in space. And where it is moving.
Simone Biles of the United States, applauds as teammate Sunisa Lee receives the bronze medal for the uneven bars during the artistic gymnastics women's apparatus final. AP
"So one is where is the position of the body in space which is called proprioception and the other one is in which direction is the body moving in the space which is called as kinesthesia sensation."
These receptors send signals to the brain and then the brain perceives it and acts accordingly. If you have to eat food, the receptors tell you your food is down, your fingers have to go, your hand will go to the food and your hand will move to the mouth. The receptors tell the brain to function here. And the brain tells the body.
"What happens exactly in twisties or freezing, whiskey fingers, etc is that this connection gets broken between the brain and the body. So that is what is called twisties."
Swaroop Savanur, mental conditioning coach and a senior sports psychology consultant, who has worked with Punjab Kings, National Cricket Academy, and India U1-7 Football team in the past, gives more insights into this mental condition. He said that such mental blocks are bound to happen especially during big tournaments like Olympics.
He told Firstpost, "It is the subconscious build-up of pressure that gets exposed under severe stress. When that happens, all these stress hormones kick off a chain of reactions that create not only the mental manifestation but also the physical manifestation. And when that happens obviously the athlete feels heart rate increasing, huge amount of negative thoughts, complete restlessness, unable to gauge anything. And when that happens, a point comes when the athlete cannot just take it anymore."
Can mental blocks be life threatening in gymnastics?
In the case of Biles, the build-up pressure was huge. She is a four-time Olympic champion and was on the verge of history in Tokyo. There was a combined personal/emotional pressure and external pressure. There came a stage when she could not take it anymore and decided to skip the events. The question is, should she have still gone for the sake of her supporters, country, and fans?
Is this the right way of looking at this? Absolutely not.
Biles must be appreciated for the decision as she must have dealt with a lot of emotional pressure before taking the call. Her going on with the competition with the prevailing mental block would not have just avoided medals but could have cost her a life-threatening injury.
Swaroop explains: "If you see, athletes experience such kind of anxiety even in other sports. But in gymnastics, that stress can be threatening because whenever you are under that kind of stress, the coordination between the brain and body actually vanishes. It reduces. So the fine motor coordination that is required to express those movements can be disturbed. When that happens, obviously the technical perfection that is required is not there and the landing can be wrong and life-threatening.
"In golf, it is called Yips. The anxiety is manifested in the manner where the player is unable to hold the club. Imagine the amount of stress that is there that the golfer is unable to even hold the club and it sometimes falls on the ground.
"In golf, it is not life-threatening, in gymnastics it is. It is great she could realise that she had twisties. She could recognise it and she dealt with it in the right way."
Simone Biles, of the United States. AP
Causes for mental blocks in athletes
"It happens due to several reasons. There are certain neurological conditions or disorders that affect the brain. What happened with Simone Biles, mostly is a kind of disorientation that can happen because of anxiety. It can be because of stress or mental pressure," said Shikha.
"When so much is expected of you, brain starts thinking of so many things. Brain has a lot of inputs; there is so much chemical reaction going on that the main thing the brain forgets. Hence there is a mental block due to which the main focus kind of diverts from the skills they are supposed to do. Because of excessive accumulation of thoughts."
What is the cure and how can athletes recover from it?
It is very important to keep taking breaks if such a mental condition occurs in athletes.
"There is no harm in taking a break. This break could be of five hours, five days, or five months. You can recover from it in two sessions also, you can recover from it in two months also. It is like that. The main thing is to find the cause behind its occurrence which is actually the role of the team psychologist. They play a very crucial role in it.
"The cause can be sometimes personal factors of the athlete, sometimes because of the expectations, of the fans, of the coaches etc. Sometimes it could be the lack of recovery. Like for many nights, they have not slept. Almost everyone today goes through this because of work-life imbalance, the kind of lifestyle we have. It is there in every human being. It is just that some people know it, some don't know about it."
Swaroop too stresses the need for a sports psychologist for all teams and players to accelerate recovery.
He said, "It is very difficult to understand. Athletes' mind is always under emotional stress, it is very difficult for our own self to be aware of it. That is exactly why athletes need to be mentally trained to manage these things. That is where the role of the mental conditioning coach comes in. That athlete is given the specific strategies that will work for her or him. So that whenever he or she has that stress, it really does not reach this stage.
The second aspect is the athletes need to be more aware. Awareness will come when the athletes talk openly about the mental side of sports. Who will the athlete talk to? He or she cannot go up to coach all the time. That is where a mental conditioning coach comes in. If an athlete works for a long time with that coach, he or she can understand what is happening to the mind, what is happening to the body because of the stress, and start using certain things that will manage the stress and stop it then and there.
England all-rounder Ben Stokes took break from cricket to look after his mental health. Image credit: Twitter/@englandcricket
Shikha said that she has been working on prevention for a long time. As the cliche goes rightly, it is always better than cure. It has to come from all aspects. And there are two key aspects here.
"It has to come from athletes first. From athletes, they have to be cautious with breathing. They have to be soft with themselves. It is not always right to be aggressive all the time. This win-at-all-cost is not always the right approach, specifically at the cost of your own health."
The next point that athletes must take care of is the recovery period.
"Recovery is important. Everything needs recovery, from organs to brain to muscles. If the recovery is not proper, the athlete will definitely end up like this."
Adding to the point, she said the next aspect is that of the coaches and managers, who need to be aware of the mental side of the athlete as well.
Adding his opinion on prevention, Swaroop says, "Like there is a relationship between a training coach and an athlete that is necessary, the same kind of partnership is very much required between athletes and mental conditioning coach. If that communication is not there, then certainly the athlete is going to feel alone. Then the athlete is unable to talk about those fears, the fears which other person is not going to understand that what he or she is going through.
"Because there is a lack of understanding of the intensity of this, it is very natural for the support system to say. 'Don't worry you will be fine, it is okay, take a break.' It is not their fault but they are looking at it from their point of view. They are unable to look at it from the athlete's point of view. That is exactly a professional help is required."
Difference between performance pressure and mental health issues?
Many a time, especially in India, performance pressure is mistaken as a mental health issue and vice-versa. Swaroop sees it as a big mistake that can further damage the athlete.
He says it is important to differentiate between the two.
"I think the danger for me that it should not be construed that mental health is the same as mental training.
Mental health is a clinical issue that can arise because of severe stress. The mental pressure of performance is different from mental health. You can still feel the pressure of performance but that does not mean you have got a mental health problem."
He added that anxiety is very normal and is bound to happen to athletes in pressure games.
"If we start equating anxiety created due to mental pressure with mental health problems, then players will further go into a shell and not talk about it at all. Because they will think they have anxiety then I have got a mental health problem. It is not so at all.
"It is normal to have anxiety, it is normal to have performance pressure but that does not mean you have a mental health problem."