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.

 

Join the conversation! 16 Comments

  1. Excellent article. I would add that, yesterday at the Bats game, Schofield told me Senzel was about a week behind Ervin, who’s expected to come off the DL for the Bats on Friday. So it seems like hes on the mend.

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  2. Wesley,

    Nice explanation and history lesson.

    It is easier than one might imagine to have vertigo-like symptoms, particularly if one has any sinus or allergy problems (I do) and any type of air travel is involved. I always took Allegra 2 hours before a flight, for prevention.

    The search results are an indication, real or not, that Senzel really is perceived as the fulcrum of the Reds rebuild.

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  3. What we know is that it has occurred twice in less than a year and that is assuming he had no symptoms during the off season that went unreported. It could be swept under the rug as no big deal last spring, but now this is a VERY big deal.

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  4. I have a few minor bouts of BPPV a year. Sometimes I trigger it with an odd positioning of my head – say, if I look above and behind at something. My doctor prescribes Meclizine, but the side effects of it are worse for me than the actual vertigo (drowsiness, lethargy). It rarely lasts longer than a day or two for me, but it is uncomfortable. Remember that feeling of the bed spinning after too many beers? It’s like that.

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  5. This article gave good perspective on the Esasky case — that vertigo cost him his career, but it doesn’t cost everyone who experiences it their career. Very informative.

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  6. HMMMM! Perhaps we shouldn’t draft anyone named Nick?

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  7. I’m not worried it threatens his career, but this is the second straight year this has lead to significant DL time. Reds will need to keep a solid backup that we are comfortable with as starter for weeks at a time. This coupled with Scooter’s continued plate excellence makes me think Reds should hold on to him and even float some reasonable extension offers. (That said, Blandino has looked very competent recently as well.)

    As a generally scarred Cincy sports fan, I fully expect this vertigo to pop up at the worst possible time, like a postseason series.

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  8. I hope you’re right in that there’s nothing to worry about. But, here’s my takeaway from your article…1) It can hit for possibly weeks at a time 2) Can’t look up 3) Can’t fly out west.

    I don’t know what kind of treatment can combat these problems but it must or better be a darn good one bcuz I don’t see how he can have a productive and successful major league career if from time to time a player will be down for weeks at a time (how many weeks we talking about?) or if it’s gonna be impossible or nearly impossible for him to fly out west.

    As far as him possibly being out weeks at a time I suppose some of you will say that the possible amount of time he could miss would be no different than the amount of time missed by an injury prone player. Some might even say he’d still miss less time than I might think in maybe some kind of effort to downplay the seriousness. I don’t know. Maybe you’d be right. But one thing that seems evident is that most players who have this condition seem to have relatively short major league careers bcuz the vertigo just becomes too much. One player you mentioned seemed to have a long career. But I won’t know for sure until I look it up bcuz the exact number of yrs each of the players named in this article with vertigo played was not specifically mentioned. The odds would seem to be stacked against Senzel or any player with vertigo.

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    • Could be on ongoing problem for him but it could be that he goes years between bouts of BPPV, assuming that’s what it is. I’d certainly say it is concerning but I wouldn’t say that it’s going to cost him 2-3 DL trips a year yet either. He may go several years between bouts or bouts may last only a day, or a couple hours, or even a few minutes.

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  9. did the same thing not happen to votto in 08 or 09,and was traced to inner ear infection ? Seems to me he missed time twice

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  10. It is concerning, but Lebron James seems to be doing ok with it

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  11. Wes, another nice article. Thanks!

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  12. Great article. I don’t know anything about the onset of vertigo. I wonder if he had this condition or signs of it before the draft, or if it was concealed or missed by the Reds.

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  13. Another fine, well-researched article Wes!

    I suffered from BPPV a few years ago then again last year, but thankfully never had to try to play baseball with it. I can’t imagine trying to play when the symptoms are actually hitting. If it is BPPV and not a more serious condition, it is very likely that he’ll only be out of commission a week or two and that some of his bouts may only last days, hours, or even minutes. Also, I went about 5 years between bad spells of it. It’s very possible that it won’t crop up for him again for years after this bout is over.

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2018 Reds, Injuries

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