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Covid Fears Give Way to Biles’s Unseen Injury in Tokyo

Covid Fears Give Way to Biles’s Unseen Injury in Tokyo

Sunday, 1 August, 2021 - 05:00

Leading into the Tokyo Olympics, Covid-19 was understood to be a key danger for athletes, officials and the local community. So far, efforts to control its spread at the games seem successful, even as cases are spiking more widely in Japan. But now it’s time to consider another health risk that’s persisted largely ignored in elite sports for decades.

Simone Biles reminded us of this hidden injury when she pulled out of the team gymnastics competition Tuesday night (she exited the individual all-around competition Wednesday). Back in May, tennis star Naomi Osaka spotlighted these hazards after withdrawing from the French Open. Dozens before them have battled with, been sidelined by, and have overcome one of sport’s most prevalent but undiscussed problems. Now, finally, it seems safe to talk about mental injury.

After stumbling on her landing from the vault, Biles left the arena accompanied by the team doctor before returning with her right leg wrapped. Observers speculated about a physical sprain or tear. But the US’s preeminent gymnast later explained that it wasn’t her body that needed repair.

“Physically, I feel good, I'm in shape,” she told NBC’s Today show. “Emotionally, that kind of varies on the time and moment. Coming here to the Olympics and being the head star isn't an easy feat.” Earlier in the week, the 24-year-old nodded to the burden in an Instagram post, telling 5.1 million followers that “I know I brush it off and make it seem like pressure doesn’t affect me but damn sometimes it’s hard hahaha!”

Biles and Osaka received a largely sympathetic response, a reflection of today’s growing awareness of mental health issues that have been exacerbated by the Covid era. That hasn’t always been the case. At Athens in 2004, Australia’s Women’s 8 rowing team had fallen back to fifth in the final when one member simply stopped pulling with 400 meters to the finish line. She was accused of mental weakness and widely criticized by teammates and in the media. Years later, she said that pushing beyond her physical and mental limits had led to her collapse.

Tokyo’s Covid bubble, which forces athletes to travel to the games without family and friends, stay inside defined boundaries, and get tested for the virus regularly, has ensured that the case count within the Olympic Village has remained low during the first week. That’s helped vindicate the organizers’ decision to go ahead despite the risks and low support within Japan.

Yet what’s kept athletes and officials safe physically also heightened mental and emotional pressures even before the opening ceremony. Earlier this month, Australian basketballer Liz Cambage said it was too much and withdrew from the national team, noting that the lack of a support system — such as family and friends — was “terrifying,” and that she’d been suffering panic attacks. “Relying on daily medication to control my anxiety is not the place I want to be right now. Especially walking into competition on the world’s biggest sporting stage,” she posted on Twitter.

While we expect a lot from sports stars, Cambage’s admission is a reminder that athletes demand a lot from themselves. What sometimes comes across as arrogance, with braggadocious claims of being the greatest of all time — as Biles signaled with her GOAT leotard — should also be thought of as the necessary mindset needed to compete at the highest level. It takes incredible self-confidence to believe that you can launch yourself off a springboard, contort, invert and spin your body multiple times before landing safely back on earth. Such a mental demand leaves no room for self-doubt.

So if we acknowledge that an athlete with a torn shoulder or sprained ankle is best sitting out an event, we must accept that one whose mind isn’t at its peak should also be rested. And that’s what Biles did. It was also Osaka’s decision when she departed after the second round at Roland Garros, following repeated attempts by organizers to get her to press conferences.

Our understanding of both mental strength and neurological activity in sport has developed dramatically over the years. Doctors and researchers have sought to find the connection between the brain and the body in the realm of elite performance, and in so doing better comprehend how mental and physical strength interact. In 1996, South African scientist Tim Noakes postulated that the body doesn’t perform in a vacuum, but is closely regulated by the brain. His central governor theory — that fatigue is not a physiological state but a brain-derived emotion used for protection — was controversial at the time, but has gained wider acceptance and helped advance our understanding of true physical limits. This can be demonstrated in numerous research experiments where subjects were tasked with exercising until they’re totally exhausted, and then required to put in a short burst of intense effort — seen as proof that such fatigue was perceived and not necessarily physical.

Yet perception is reality. Trainers, coaches, and sports-medicine doctors help an athlete build up the requisite skills and put them into top physical shape to perform at their best. In recent decades, sports psychologists have been brought in to help them get into mental shape, find focus and push themselves to reach those physical limits.

The flipside is injury. When we build our bodies to maximum capability, then push to perform at the edge, physical breakdown is bound to happen. Every athlete understands that injury is not only a fact of life, but that the right training plan is optimized to avoid it. They also know that powering through will worsen the problem, with the best course being to rest and repair the body before starting a recovery process.

That same approach needs to be taken with the hidden injury of mental distress. Training regimes should be optimized for psychological health, and recovery programs put in place when breakdown occurs. Unfortunately, few athletes truly understand their own mental health. I, too, have burst into tears at the end of an Ironman triathlon race, unsure whether the emotional response was elation from finishing the grueling 226 kilometers (140.6 miles) of swimming, cycling and running or the disappointment of not doing better.

Similar tears are shed by amateur and elite athletes before, during and after competition with little understanding of the cause or their underlying mental state. We all know that elite performance is in the mind, but we still lack clarity on the mechanisms that underpin that process.

Thankfully for all of us, we have the leadership of heroes like Simone Biles to navigate such uncharted territory on our behalf. By understanding herself, her needs and the way forward, she’s earned the title of GOAT and turned these games into a new example of sporting excellence.


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