LAS VEGAS – During the closing keynote at HIMSS25 on Thursday, Simone Biles – athlete, advocate, the most-decorated gymnast of all time, seven-time gold medalist, GOAT – capped off a week of inspiration and innovation with a talk about her own story of success, self-worth and perseverance in the face of enormous challenges.

In a wide-ranging onstage discussion with Valorie Kondos Field, NCAA gymnastics champion and coach – who aptly noted that “gymnastics is a hard, hard sport” that puts enormous pressure and pain on both body and mind – Biles spoke about her life story. 

Placed into foster care. Adopted, with her younger sister, by her grandparents, who provided a supportive and nurturing environment that cultivated her undeniable athletic talent. Rocketing to the stratosphere of the gymnastics world in her teens. 

Competing in three Olympics and winning 11 medals across them. Add 30 World Championship medals for good measure. All earned by her explosive power and near-perfect execution of exceptionally difficult vault, floor and balance beam events.

It was in one of those three Olympics, of course, that Biles’ athletic career became truly interesting, when she developed a mental block – the “twisties” – that prevented her from being able to perform at her usual stratospheric level, and made it dangerous to perform the precise kinetic feats she was famous for.

Even though she won a bronze individual medal and a silver team medal in Tokyo 2020 (actually played in summer of 2021, after being delayed by the COVID-19 pandemic) her decision to prioritize the team’s success, and her own wellbeing, by withdrawing from several events put her under criticism from a minority of ill-informed critics. 

But the vast majority of fellow athletes and the general public applauded her for putting her own health and well-being first.

After taking some time away from the sport to work with a psychologist, Biles returned to the Olympics at the 2024 Paris games – at age 27, the oldest American gymnast since 1952 – for a phenomenal comeback: three more gold medals and a silver.

At HIMSS25, Biles emphasized the importance of looking out for one’s own physical and mental health, and of relying on the goodwill and support of friends, family, teammates – and healthcare professionals – wherever one can find it.

In fact, Biles has been seeing sports psychologists on and off since her early teens. And throughout her career she has enjoyed the support of an empathetic and insightful team.

“Her coaches and her parents protected her from her talent,” said Kondos Field.

Biles says she’s always managed to avoid burnout. From early in her career, “I was very transparent with my coaches. If I wasn’t feeling well enough that day, if I wasn’t feeling mentally well, I would text them: ‘I’m going to take a mental day because it’s way better than to have your mind 100% in it than to not.'”

Before Tokyo ’20, during  training, Biles was “literally in the best shape of my life. I’ve never felt better,” she said.

Then the pandemic came, and it looked like the Olympics would be postponed or cancelled.

“I was devastated,” said Biles. “I was like – there’s no way my body can do it for another year. So what are we going to do? My coach said, ‘Take some time off, go home. We’ll have some workouts in a couple of months, and then we’ll start the rebuilding process.'”

When the games finally came in ’21, irrational doubt had entered her mind.

“I neglected my mental health because I was so focused on my physical health,” she said. “I was so terrified that I’m going to get physically injured in the gym.”

Going into Tokyo, “I could sense that something was off.” 

The twisties, said Biles, are when “your body and your mind are not in sync.” It’s like someone who drives every day, doing all the steering and braking and maneuvering by instinct and experience, suddenly forgetting how, she said.

The consequences of being off kilter, even by a tiny bit, when doing acrobatic mid-air twists, could have been disastrous.

Still Biles did not want to quit on her team. She says her mom was the one who gave her permission to focus on herself. “The team will be okay,” Biles says she told her. “You’ve led them to this point. They’re going to be fine. I’m worried about you.”

Biles leaned heavily into sports psychology, working intensely to prioritize her well-being and get back on track using techniques such as eye movement desensitization and reprocessing, or EMDR.

“We can’t do it alone. If God gave us all the tools, then we’d all be amazing” she said. “But sometimes, you just have to pay someone for it,” she said.

Going forward, Biles says she’ll continue to be a vocal advocate for self-care and prioritizing mental health.

“It’s really important,” she said. “I see more athletes getting the help that they deserve and speaking out on their mental health journeys. 

“At the end of the day, we’re still human,” she added. “We still go through things. We still have these little voices in our heads that we can’t do it, or to be anxious or to be scared. I can’t say what will work for you, but I can walk this journey with you.”