Two falls on the world stage are no problem for the greatest gymnast to grace the mat.

Simon Biles, who began the 2018 gymnastics World Championships with a late-night trip to the ER, won her fourth world all-around title Thursday in Doha, Qatar, despite falling twice in the four-event competition. It’s the first falls for Biles in 60 career Olympic or world champion routines, according to NBC Olympics writer Nick Zaccardi, and she assured fans it wouldn’t become a regular occurrence.

Biles, 21, won with 57.491 points to best Japan’s Mai Murakami by 1.693 points. It’s the largest margin in the women’s all-around worlds under the Code of Points, the scoring system instituted in 2006 that did away with the perfect-10. USA teammate Morgan Hurd placed third with 55.723 points.

The fourth title is also a record, breaking her tie with retired Russian gymnast Svetlana Khorkina for most world all-around golds.

And that’s after taking 14 months off following the 2016 Rio Olympics, where she won three golds and a bronze.

Biles has shaky start on vault

Biles debuted a difficult vault at the competition’s qualifying rounds. She is the only woman in the world to do a roundoff with a half-twist onto the vault and a front double full somersault off of it. It adds a half-twist on the back end.

In the all-around finals she sat down on the opening vault and lost points.

“And although that is shocking, it really means almost nothing for Simone because she started basically a full point ahead in start value,” the NBC Sports announcer said.

She earned a 14.533 to fall slightly behind teammate Hurd (14.600) and Japanese competitors Asuka Teramoto (14.633) and Murakami (14.566).

Biles fights to save balance beam performance

The same event that gave her pause in the team final, which the USA won for a berth at the 2020 Tokyo Olympics, gave her some trouble in the all-around.

Biles scored a 13.233 on the balance beam, one of the lower scores for those who finished top-10 overall.

Difficulty level sets Biles apart

Biles was the best on the uneven bars with a 14.725 and in the floor exercise with 15, both at least one full point above Murakami.

It was on the floor she put the victory away after leading by .092 points going into it. Biles is consistently one point better on the floor routine than the rest of the world.

The difficulty of what Biles does puts her above everyone before the first gymnast even begins. She goes into the event with a higher “start value” due to difficulty, allowing her to fall back on those points if something goes wrong in her routines, as it did Thursday.

Adding to the difficulty in this world competition is a kidney stone she named “Doha Pearl.” She spent Friday night into early Saturday morning at the ER hours before the competition began, but “Doha Pearl” was too big to pass.

More to come for Biles this weekend

Biles now has 12 world gold medals, tied with retired Belarusian Vitaly Scherbo. She can overtake that Friday and Saturday with the apparatus finals where she’ll have four shots at a gold.

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