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TOKYO — Gymnastics superstar Simone Biles confronted her fears Tuesday and returned to competition in the balance beam final, after she shocked the world by withdrawing from several competitions to focus on her mental health.

Widely considered the world’s best gymnast, Biles, 24, looked focused and relaxed during a pre-competition practice and was smiling and even laughing at one point after she landed her dismount from the balance beam.

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Earlier, Biles revealed she was still suffering from “the twisties” and “literally cannot tell up from down.” But there was no obvious sign of any such anxiety as she went through her paces and did her stretching exercises.

Simone Biles warms up before the Women’s Balance Beam Final at Ariake Gymnastics Centre on Tuesday. Laurence Griffiths / Getty Images

The balance beam competition began at 5:50 p.m. (4:50 a.m. ET) at the Ariake Gymnastics Centre in Tokyo.

Biles stunned spectators last week by withdrawing during the team gymnastics final. She said the emotional toll of the Tokyo Games, not a physical injury, prompted her to withdraw.

“Physically, I feel good. I’m in shape,” she told Hoda Kotb on NBC’s “TODAY” later. “Emotionally, it varies on the time and moment. Coming to the Olympics and being head star isn’t an easy feat.”

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After that, Biles pulled out of other events including the individual all-around and uneven bars finals, raising fears that she was through with the Games.

Her announcement Monday that she was returning to competition was celebrated by fans the world over.

The Tokyo Olympics were meant to be a showcase for the four-time gold medalist. Instead, Biles found herself thrust into the conversation around mental health and sports.

“For anyone saying I quit, I didn’t quit, my mind and body are simply not in sync as you can see here,” Biles wrote Friday in an Instagram post. “I don’t think you realize how dangerous this is on hard/competition surface. Nor do I have to explain why I put health first. Physical health is mental health.”

Corky Siemaszko is a senior writer for NBC News Digital.

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