Metro area — She was on the bottom of the pile.

And as the competitive cheer team pyramid came tumbling down, the Ladywood junior was kicked in the head.

Over the weekend, she suffered headaches and dizziness, symptoms of a concussion.

Back in school on Monday, she was referred to the Henry Ford Health System’s concussion clinic, where a neurological screening was done to compare with a base line screening performed earlier in the school year.

The Livonia school is one of five Catholic League high schools that contract with Henry Ford to perform a computerized concussion screening program — named “Impact” — on all of its athletes, including, at Ladywood, members of the competitive cheer team.

The other schools are Bloomfield Hills Brother Rice, Bloomfield Hills Marian, Farmington Hills Mercy and U-D Jesuit.  Marian and Ladywood cover the costs of the screening out of their operating budgets, while expenses at Mercy are taken care of by the Dads Club and at Marian by the Athletic Club.

“We got into it for the health of our kids,” said Ladywood Athletic Director Sal Malek.

Every athlete is mandated to take the 30-minute test in their freshman and junior years, usually done in the school’s computer lab, to establish a base line of the brain’s different activities, according to Meaghan Rourke, who is on the Henry Ford staff half-time and 20 hours a week as Ladywood’s athletic trainer.

“We measure things that are affected when you have a concussion,” she said, “such as memory recall, accuracy, balance, etc. When a student has a concussion, then we compare the post-concussion screening to the base line to determine the severity of the concussion.”

The Ladywood student was sidelined for five days and returned to competition with the authorization of a physician, according to state high school and Catholic League rules.

Even then, said Rourke, a 2002 Allen Park Cabrini graduate where she is also athletic trainer for football and hockey, the student must follow a two- or three-day return-to-play protocol to assure that the student is symptom-free.

In May 2010, the Michigan High School Athletic Association tightened its playing rules for the current school year regarding concussions. Officials have no role in determining a concussion as they did previously except to point out the possibility to a coach, who in turn calls upon an on-site health care provider for an examination.

An athlete who suffers a concussion may not return to competition until he or she is cleared in writing by an MD or DO.

In the Catholic League, all incoming freshmen, whether or not they participate in athletics, must have a complete physical exam, according to Vic Michaels, CHSL Athletic Director. “We want to make sure students are healthy to compete in sports or in physical education classes.”

In the remaining years of high school, athletes must take annual sports physicals.

This spring, the MHSAA’s governing body, the  Representive Council, of which Michaels has been a member for eight years, approved a revised physical exam form with a focus on heart health.

The recent tragic death of the Fennville basketball player in western Michigan who collapsed and died from a sudden cardiac arrest (SCA) after making a game-winning basket cast a national spotlight on a medical mystery that has perplexed health care providers and frightened parents of athletes.

About 50 to 100 sudden deaths occur among athletes in middle school, high school and college every year, says Dr. Marlon Rosenbaum, of the Columbia University College of Physicians and Surgeons.

Since 1999, 47 students have suffered SCA in Michigan — including Thomas Winfrey, a 15-year-old basketball player at Detroit East Catholic in 2003. This is according to records compiled by the Troy-based Kimberly Anne Gillary Foundation, named after a 15-year-old Troy Athens High School student who died in 2000 while playing water polo.

Kimberly’s sister, Emily Kucinich, the foundation’s program administrator, said that the foundation, whose mission is advocacy for cardiac screening and testing of all high school athletes, worked with the MHSAA and other professional and medical organizations in re-formulating the state high school’s physical exam form to include sections dealing with the student’s and his or her family’s heart health.

The costs of the exams, and heart screening if such is deemed necessary by a physician, are the responsibility of parents or guardians. “How much testing and how much risk in continuing to participate are decisions that are better left to the families involved than anyone else,” says Jack Roberts, MHSAA Executive Director.

Michaels stressed that the “ultimate responsibility” for a player’s eligibility, i.e., if the student has had a properly certified physical exam on file, belongs to the coach.

He added: “Our schools are all doing the right thing when it comes to the safety and health of students.”

In addition to advocating for cardiac screening and testing of all high school students, the Kimberly Anne Gillary foundation’s other mission is to ensure that every Michigan high school has at least one automated external defibrillator (AED) and staff members who are trained in CPR and the use of an AED. To that end, 16 Catholic League high schools are among nearly 600 schools statewide who have accepted the free AEDs. For more, log on to http://www.kimberlysgift.org/about.html