Pressure on Jarred Cosart builds as vertigo symptoms subside

The Miami Marlins pitching staff received another scare on Friday during their Spring Training game against the Washington Nationals.

Jarred Cosart was sent to the trainer to assess if there was any ligament damage to his right leg after a collision with Martin Prado.  Luckily, the injury was only a bruised knee.  Despite this welcoming news, there are still lingering concerns about Cosart's health and/or ability, leading the Marlins' front office to announce there will be an open competition for the two starting pitching rotation spots after Jose Fernandez, Wei-Yin Chen and Tom Koehler.

Last season, Cosart suffered from recurrent bouts of vertigo that essentially ended his season in May.  His multiple relapses of vertigo indicated he may have a chronic disorder.  In an article last August, Michael speculated that Cosart may have Meinere's Disease.  Meniere's Disease is a vestibular (inner-ear) disorder that affects the membraneous labyrinth of the ear.  Its cause is unknown and there is currently no cure.  Symptoms include vertigo, ringing in the ear, and progressive deafness.  After being diagnosed with an inner-ear disorder by a specialist in Chicago, Cosart underwent vestibular rehabilitation therapy.

Vestibular rehabilitation is a customizable exercise-based treatment that can be used to reduce the symptoms of vertigo.  The actual therapy is patient-specific, and Cosart briefly described his rehabilitation process to Craig Davis of the South Florida Sun-Sentinel:

"I was in there for two hours, twice a day, doing all sorts of exercises in dark rooms, following a lot of flashing lights around. Not fun. A lot of combating dizziness is to make you dizzy. I'm happy it's over."

This sounds like a "habituation exercise," a hallmark of vestibular rehabilitation therapy.  The purpose of this treatment approach is to design exercises that increase a patient's dizziness temporarily, and then allow the symptoms to subside.  Eventually, this trains the brain to "ignore" signals from the inner ear, decreasing the intensity of vertigo.   Undergoing habituation exercises is actually an indication that Cosart may not have Meniere's disease.

Typically, habituation exercises are used to treat symptoms of vertigo that are caused by self-motion and visual stimuli. Symptomatically, Meinere's disease is associated with unexpected sudden bouts of vertigo, and habituation exercises would not be used to treat these types of symptoms.  This is a good sign for Cosart's overall prognosis, as vestibular rehabilitation can improve the symptoms of patients with inner-ear disorders of this nature that only impact one ear. Furthermore, Cosart claims the doctors told him he doesn't have to worry about relapsing again.

However, it is clear that the Marlins brass are still skeptical of Cosart's overall health.  Ironically, another way to reduce symptoms of vertigo is stress reduction.  Unfortunately for Cosart, he has been put under significant pressure after hearing that two rotation spots are up for grabs during Spring Training.  Here is a quote directly from Cosart courtesy of the Miami Herald:

"I'd like to think that I have a spot. But, apparently, it's been made known by the front office that there's two up for grabs. I have confidence in myself that I'm going to win one of those jobs."

Furthermore, Cosart is definitely feeling the pressure.  After colliding with Martin Prado, he refused to be removed from the game.  Here is another quote from him describing what happened during a mound visit after the collision:

"I told them if they took me out, I was going to freak out."

That does not sound like a pitcher who believes he is a lock for a rotation spot.  These are strong indications that the front office is skeptical of Cosart's health and/or ability to perform.  If Cosart is threatening to "freak out" if removed from a Spring Training game, this indicates there truly is competition for the remaining rotation spots after Fernandez, Chen and Koehler.  Cosart is going to have to earn it.  To do so, he will have to improve on a poor 2015 season and remain healthy.