Simone Biles and the "Twisties"

Unless you've been totally off the grid, you've undoubtedly heard of the great Simone Biles. And in the last week you've been inundated with news about Simone and the "Twisties". Of course we are all disappointed that we did not get to marvel at the gymnastics skills of the GOAT this past week during the Olympics. Let's break down what happened to Simone and how it applies to pediatric physical therapy and your baby.

First some background. I was an average child gymnast. I love the sport and have remained an avid fan for life. I love watching the girls and the creativity of the moves they do. My 21 year old daughter was a better than average gymnast for almost 10 years and I lived the life of a gym-mom. Observing gymnasts learn skills offered me a lot of insight into my theories about teaching motor skills. Being an involved parent at my daughter's gym also put me in a position to have seen the GOAT compete in person as a young child starting out. (I also have seen Oksana Chusovitina - the 43 year old vaulter and Rebecca Andrade of Brazil - Olympic Silver AA and Gold medal vaulter in person). I've seen a lot of gymnastics in my time.

Have you ever woken up in the dark and felt turned around or disoriented in your bed? This is a more simplified version of what happed to Simone in the middle of her vault. This is called Kinesthetic awareness and proprioception. Kinesthetic awareness refers to our ability to navigate space and the awareness of how we move. "Kinesthetic awareness and proprioception work as partners to get us through the movements of our lives from the inside and the outside of the body. Muscle memory is a kinesthetic concept." We get this information in several ways. Proprioception is felt through mechanoreceptors in the joints that given us information about how we move. Another one is vision - we see where we are in space. Another is our vestibular system which is in our inner ear. The semicircular canals in the ear tell us up from down, sideways and incline. When you have an ear infection it often effects your balance. We also get information from the cerebellum about balance and fluidity of movement.

In the case of Simone I cannot say what happened exactly, but if she was unable to determine her position in space, the skills she performs become very dangerous. She learned these skills through repetition which helped her develop muscle memory. I've seen girls experience a change in their routine (for example, a change in their steps as they run to the vault table) and it causes catastrophic results. Simone most definitely made the right choice for her in this situation.

So back to babies. They are also learning about their movements and their body position in space. In utero they experience a very cushy environment suspended in amniotic fluid. Once they are born they begin developing all the sensory systems. When we keep our baby in supine (on the back) all the time we don't allow their sensory systems to develop because they are fully supported and still. Babies get a lot of vestibular input when we bounce them (gently), hold them upright and walk with them, place them in tummy time and encourage them to lift their heads, swing them back and forth and so on and so forth. They don't get a lot of input when we place them in containers that keep them from moving. (Containers include mamaroos, swings, carseat carriers, bassinets with swaddles and many more.)

PTs know you have to go to cook dinner and you need your baby to sleep. So if you are using some of the above to help you function as a new and overwhelmed parent, we support you! I recommend reaching out to a pediatric PT to get some education as to how to purposefully play with your baby to allow the sensory systems to begin to develop. Poor development of these systems may be why your baby hates tummy time or is not rolling over and later is a late crawler or walker. Repetition of movements helps your baby develop kinesthesia and proprioception just like it helps Simone Biles perfect her routines and make them look easy as she performs them.

One other thing to note about the "twisties". Everyone's vestibular system is different. That's why some people love rollercoasters and go skydiving while other people hate the 3rd floor of the Galleria. Simone has an extraordinary vestibular system with keen kinesthetic awareness. That's how she knew immediately that she needed to withdraw from competition. We don't need to have that kind of ability BUT we do need to be able to walk, run, turn in a circle, sit up from laying down without becoming dizzy. If you feel your baby needs some help developing this important part of the brain and nervous system reach out to a pediatric PT. We can make it fun and a lot less stressful.