The withdrawal of Simone Biles from team competition in Tokyo surprised Olympic spectators, but it came after years of stress and pressure on the greatest gymnast of all time.

She won’t be able to participate until Thursday, according to a new medical examination. The announcement came following her stunning decision to withdraw from the women’s team event on Tuesday after only one rotation on the vault due to mental health problems.

She stated that she took the decision in consideration of her colleagues’ chances of winning an Olympic medal. In the end, Team USA received a silver medal, while the Russian Olympic Committee received a gold medal.

Biles is the best gymnast of all time, and she was expected to lead Team USA to another Olympic gold medal in the team event. However, only minutes into the competition on July 27, Biles sat on the sidelines, engaged in a serious chat with a trainer, and then exited the field of play.

Biles claims that mental health issues forced her to withdraw from the US team’s highly anticipated match against Russia on Tuesday.

However, a statement from US Gymnastics left open the potential that Biles, who may still participate in four more finals, will return to the Games for the individual competitions next week.

Biles, 24, told media after her vault that she opted to withdraw from the competition because she was “struggling with some things.” She went on to discuss her mental health and the enormous pressure that comes with being an Olympic competitor, especially after such a “long year.”

Biles qualified for the all-around event on July 29 and the finals of all four apparatus events on August 1, 2, and 3. There was no announcement made to the virtually empty arena because there were no fans there who would have needed to know what was going on.

“It’s been really stressful, this Olympic Games,” Biles remarked, referring to the peculiar conditions in Tokyo, where the public is not permitted to attend events.

“It’s been a long week, it’s been a long Olympic process, it’s been a long year,” she added.

“I think we’re just a little bit too stressed out,” she said. “But we should be out here having fun — and sometimes that’s not the case.”

US gymnastics said “After further medical evaluation, Simone Biles has withdrawn from the final individual all-around competition,” it stated. “We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her wellbeing. Her courage shows, yet again, why she is a role model for so many.”

Biles made her Olympic debut in 2016, representing the United States and winning five medals: four gold and one bronze.

Biles stated that the stress of participating in the Olympics, as well as the cumulative weight of competing in a pandemic Olympics after enduring a year of lockdowns and limitations, had finally taken its toll. Days after landing in Tokyo, one of the team’s alternates tested positive for COVID-19, while another was placed in isolation due to her close contact. “Today was really stressful,” she said. “The workout this morning went okay, it was just the 5.5 hour wait—I was shaking, and barely napped. I’ve never felt like this going into a competition before. I tried to go out, have fun and after warming up in the back I felt a little better, but once I came out here, I felt, no, the mental is not there. I need to let the girls do it and focus on myself.”

Biles became the latest famous athlete to confront the mental components of high-stakes competition — and the challenges that are frequently unseen to the public — by speaking frankly about her battle to get into the correct mentality for the team final.

Jade Carey, who came eighth in qualification, will replace Biles in the all-around competition. Carey was initially not qualified because she was the third-highest-ranking American, after Biles and Sunisa Lee. Countries are only allowed two competitors each event in the finals, according to International Gymnastics Federation regulations.

On the subject of mental health, Biles said: “Therapy has helped a lot, as well as medicine. That’s all been going really well. Whenever you get in high-stress situations, you kind of freak out and don’t really know how to handle all of those emotions especially at the Olympic Games.”

“This Olympic Games I wanted it to be for myself. I came in and felt like I was still doing it for other people. That just hurts my heart that doing what I love has been kind of taken away from me to please other people.”

“I have to put my pride aside. I have to do what’s right for me and focus on my mental health and not jeopardize my health and well-being. That’s why I decided to take a step back.”