If you Google “nick senzel vertigo,” the search engine will return 5,660 results in 0.52 seconds, with the first reading “Vertigo behind him, Nick Senzel ready to help the Cincinnati Reds.” The headline gives false promise, talking about Senzel’s first bout of vertigo, not this current second iteration. For up-to-date information, it only takes looking at the second search result: “Reds’ Nick Senzel: Placed on DL with vertigo.”
He’s the club’s top prospect, but Senzel isn’t quite ready to help the Cincinnati Reds and at the moment, no one is really sure when he’ll be ready to help the Louisville Bats again either. Despite its prevalence amongst American society, vertigo is more uncommon amongst Major League ballplayers and treating it lies beyond the pale of standard injury remedies. No surgery, no cortisone shots, no rehab — just rest and head positioning exercises. So what can we expect from Senzel’s vertigo diagnosis going forward?
WHAT IS VERTIGO?
Take a moment, if you are able, to stand up and spin in place five, six, seven times as quick as you can before sitting back down. Notice how the world is still spinning even though you are still? Notice the light-headedness and disorientation? Those are the symptoms of vertigo, induced for only a moment. When afflicted by the actual malady, those symptoms can last hours and even days, leaving your entire world just a bit off-kilter.
Actual vertigo arises because of disturbances in the inner ear, whether that is due to inflammation, fluid buildup, or injury. However, some instances of vertigo originate in the brain/spinal cord, though those cases generally result from brain tumors or long-term conditions like multiple sclerosis.
Given what we know about Senzel’s previous treatment and how he, club president Dick Williams, and agent Scott Boras have talked about the vertigo, it feels safe to assume that Senzel suffers from benign paroxysmal positional vertigo (BPPV). The most common form of vertigo, BPPV occurs when debris fragments in your ear are shifted into the fluid-filled ear canals, causing your brain to receive mixed signals about balance. BPPV can occur without rhyme or reason, but can also be caused by infection, injury, or surgery.
While BPPV vertigo can clear up on its own after several weeks, one option for treating the condition is the Epley Maneuver, a series of head movements meant to move the debris away from the ear canal.
IS THERE PRECEDENCE IN BASEBALL?
Yes. In fact, the most famous case was another Red named Nick.
In 1990, Nick Esasky, having just signed with his hometown Atlanta Braves, began experiencing the symptoms of vertigo eight games into his Braves career. After bruising his shoulder in the ninth game, Esasky never played baseball again.
For months after symptoms first developed, Esasky searched for any doctor to diagnose the root of his dizziness. Finally, neurologist Jeffrey Kramer made the diagnosis of vertigo and began working with Esasky to get him back on the field, but that particular dream never came to fruition.
For Esasky, a power hitting first baseman, being able to see the ball was everything, but with vertigo, he just couldn’t. Esasky told People magazine in 1991, “I couldn’t see the ball until it reached me, and I’d just say, ‘Okay, I hope it’s going to be where I think he’s throwing it, and if it’s anything else, I’m in trouble.’ Usually I was in trouble.”
When he was still trying to retake the field, Esasky had to retrain his brain. His inner ear damaged, Esasky did exercises that a) strengthened the other two facets of our balance system, our eyes and our feet, and b) acclimated him to strenuous activity while sick and dizzy. If that second part sounds particularly sadistic, Esasky thought so too. But the point was to retrain Esasky’s brain to be immune to nausea and dizziness, even if that meant jumping up and down with his eyes closed until he couldn’t jump anymore.
While Esasky’s is the most extreme case of vertigo in baseball, it’s not uncommon by any stretch of the imagination. In the past three years alone, Jarred Cosart, Brock Holt, and Stephen Drew have all dealt with symptoms of their own. Cosart is currently out of baseball, though that’s probably more talent-related than vertigo. Holt is on a tear with the Boston Red Sox this year. And Drew retired this past offseason, but for age and declining productivity reasons.
The biggest problem with vertigo and baseball is that it makes the game impossible. Whereas with a sore shoulder or bum ankle, one could play — just not at full capacity — that’s not the case with vertigo. Looking up can disorient you again; tracking a curve ball is a nightmare; and don’t even think about flying out West with the havoc cabin pressure changes can have on the inner ear.
If Brock Holt is any indication, players can overcome vertigo and be productive again. It’s just probably the one baseball injury you absolutely cannot rush back.
SO WHAT’S THE DEAL WITH SENZEL?
Understanding that Esasky’s case was the most extreme baseball has seen, I wouldn’t be too worried about Nick Senzel. If I were to put together an armchair diagnosis for why Senzel’s BPPV has reoccured, I would hazard a guess his awkward dive for a ground ball at the end of April dislodged some debris again.
No one in Senzel’s corner is too worried about the infielder either. Dick Williams told C. Trent Rosecrans of The Athletic, “We feel like we’ve got a good treatment plan in place. We believe it’s realistic to see him back on the field in short order.” In that same article, Senzel’s agent Scott Boras laughed at the idea that Senzel’s situation was anything like Esasky’s: “We’ve had a lot of players who have had a diagnosable dizziness. To suggest that it’s going to evaporate into something that’s going to cost somebody their career, no.”
There’s nothing to worry about. Take a deep breath and repeat that until your own lightheadedness disappears. If anything, the DL-stint just allows Senzel more time to be fully healthy and vertigo-free next time he takes the field.
Just maybe don’t go Googling for more information. That first result will still be a tough pill to swallow.