The 24 year old Simone Biles, the most successful US gymnast of all time and winner of four gold medals and a bronze at the 2016 Games, huddled with a trainer after her opening vault, which scored 13.766, the lowest mark of the first rotation.

Biles then exited the competition floor with the team doctor, before returning several minutes later with her right leg wrapped. She took off her bar grips, hugged team-mates Grace McCallum, Sunisa Lee and Jordan Chiles before putting on a jacket and sweatpants.

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However, the Americans finished second to claim silver behind the Russian Olympic Committee team who won gold, with Great Britain taking bronze. Biles said she will “see what happens” in regard to her availability for the all-around final on Thursday night and the event finals later in the Games.

Asked after the event if she was injured, Biles said: “No. Just a little injury to my pride. After the performance I did, I just didn’t want to go on. I have to focus on my mental health.

“I just think mental health is more prevalent in sports right now… we have to protect our minds and our bodies and not just go out and do what the world wants us to do.

“I don’t trust myself as much anymore… maybe it’s getting older. There were a couple of days when everybody tweets you and you feel the weight of the world.

“We are not just athletes, we’re people at the end of the day and sometimes you just have to step back. I did not want to go out and do something stupid and get hurt. I feel like a lot of athletes speaking up has really helped.

“It’s so big, it’s the Olympic Games, at the end of the day we don’t want to be carried out of there on a stretcher. You have to be there 100 per cent or 120 per cent or you’re going to hurt yourself.”

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