'A test can't undo a concussion': Walsh HIA process explained

NRL GM - Elite Football Graham Annesley has moved to clarify the head injury assessment process and why Reece Walsh will miss Brisbane's match against Souths, despite passing a HIA test during Origin I.

Walsh was ruled out of last Wednesday night’s Origin series opener in the eighth minute after a high tackle by NSW centre Joseph Suaali’i, who was sent off and suspended for four matches.

The NRL’s independent doctor classified Walsh’s symptoms as category 1, which meant the Queensland fullback could not return to the field, as he was left momentarily unconscious by the tackle.

However, confusion arose after it was reported that Walsh had passed his HIA test in the dressing rooms.

Some questioned whether Walsh could return or if he was able to seek an exemption from the NRL’s mandatory 11-day stand down period to play for Brisbane against Cronulla last weekend.

He did not play and will also miss Friday night's match against the Rabbitohs at Accor Stadium. 

“There was some confusion created by reports that Reece, after he left the field, had passed his HIA, and that led some people to believe that he wasn't concussed and therefore would not be subject to the normal concussion provisions of standing down,” Annesley said.

“I just want to make it absolutely clear that Reece was actually unconscious, momentarily, and so that is a concussion. There are no ifs or buts about it.”

Annesley said the NRL’s independent doctors look for indicators to determine whether a player is classified as displaying category 1 or category 2 symptoms.

If a player deemed a category 2 case passes a HIA test he can return to the field, while category 1 cases are automatically ruled out.

However, those players usually undertake a HIA test before leaving the ground and perform the test again 24-36 hours later as their recovery is monitored.

“There was a test conducted and that's part of the process in commencing rehabilitation and just checking on the welfare of the player after he suffered a head injury,” Annesley said.

“But when a player responds in that way, with that type of incident, then there is no question that that is a concussion, so passing the test is irrelevant in terms of what happens to the player.

“In some cases, after it's been a category one determination, they will still go through the process of doing the test and some players recover quite quickly in terms of their immediate recovery, but a concussion can't be undone by a way of passing a test.

“Sometimes concussion signs and symptoms can follow days afterwards. A player can have headaches, nausea or a whole range of different responses that can be as a result of the incident, even though they might seem okay initially after it.”

On rare occasions, a club who believe the category one diagnosis was wrong can seek to have the player cleared to return before the 11-day stand down.

An example was Sydney Roosters halfback Sam Walker in a match earlier this season.

“The only time a category 2 call or a category 1 removal from the field can be overturned is if there is a subsequent dispute about the observation of the signs that were exhibited by the player," Annesley said.

"In very rare circumstances, that can happen. The [HIA] bunker, for example, might feel that a player exhibited a certain response to an incident but there may be another reason for that.

“For example, the player might have tripped, but the bunker didn't see that, so they saw a stumble and they thought it was as a result of the incident.”

Walsh will be eligible for selection again in Origin II after sitting out the 11-day period under concussion protocols, with the Maroons set to name their side for Game Two in Melbourne on June 17.