Michael C. Koester, MD, ATC, FAAP
Pediatric & Adolescent Sports Medicine, Musculoskeletal Injuries in Active Adults, Sports Concussion Management Specialist
14 years of experience

Accepting new patients
Slocum Center for Orthopedics & Sports Medicine
55 Coburg Rd.
Eugene, OR 97401
(541) 485-8111
Locations and availability (1)

Education ?

Medical School Score
University of Nevada (1996)
  • Currently 2 of 4 apples
Residency
University Of Washington Medical Ctr (1999) *
Fellowship
Vanderbilt University (2005) *
* This information was reported to Vitals by the doctor or doctor's office.

Awards & Distinctions ?

Awards  
GLEN E WHIDDETT MEDICAL SCHOLARSHIP (1995)
FELLOW
EXCELLENCE IN PEDIATRICS AWARD (1996)
DR V.A. SALVADORINI EXCELLENCE IN PATHOLOGY AWARD (1994)
PHYLLIS J WALSH ENDOWMENT SCHOLARSHIP (1995)

Affiliations ?

Dr. Koester is affiliated with 2 hospitals.

Hospital Affilations

Score

Rankings

  • Sacred Heart Medical Center
    Orthopaedic Surgery
    1255 Hilyard St, Eugene, OR 97401
    • Currently 4 of 4 crosses
    Top 25%
  • McKenzie - Willamette Medical Center
    Orthopaedic Surgery
    1460 G St, Springfield, OR 97477
    • Currently 4 of 4 crosses
    Top 25%
  • Publications & Research

    Dr. Koester has contributed to 16 publications.
    Title Does Shoe Insole Modification Prevent Stress Fractures? A Systematic Review.
    Date June 2010
    Journal Hss Journal : the Musculoskeletal Journal of Hospital for Special Surgery
    Excerpt

    Stress fractures can be debilitating in athletes and military personnel. Insoles may lower stress fracture rates by improving biomechanics, lessening fatigue, and attenuating impact. The objective of this study was to systematically review the best evidence on the use of insoles as a method of stress fracture prevention in a high-risk population. Using MEDLINE, Cochrane, Current Controlled Trials, UK National Research Register, ScienceDirect, CINAHL, and EMBASE, a review of randomized (level I) and quasi-randomized (level II) controlled trials was performed using an insole as the intervention and stress fracture incidence as the primary outcome measure. Five trials were included, and a random effects model was used to generate a summary estimate and an overall odds ratio. One study found a significant reduction in overall stress fracture incidence using a semirigid insole, while four studies found no overall reduction in military personnel. However, when the data are pooled, orthotic use was beneficial. When stratified by site, there was a reduction in femoral and tibial stress fracture incidence. Shoe insoles may reduce the overall femoral and tibial stress fracture incidence during military training. It is unclear if the use of insoles would prevent stress fractures in athletes. Additional studies are necessary to determine the efficacy of insoles in an athletic population.

    Title The Efficacy of Subacromial Corticosteroid Injection in the Treatment of Rotator Cuff Disease: A Systematic Review.
    Date April 2007
    Journal The Journal of the American Academy of Orthopaedic Surgeons
    Excerpt

    To investigate whether subacromial corticosteroid injections are effective in the treatment of rotator cuff disease, an evidence-based systematic review was undertaken of nine randomized controlled trials that compared subacromial corticosteroid injection with placebo in patients with rotator cuff disease. Each study was systematically evaluated for biases, and outcome measures were scrutinized for statistical significance and clinical importance. One study demonstrated clinically important differences in pain relief. Two studies showed clinically important improvement in range of motion at final follow-up. This systematic review of the available literature indicates that there is little reproducible evidence to support the efficacy of subacromial corticosteroid injection in managing rotator cuff disease.

    Title Nsaids and Fracture Healing: What's the Evidence?
    Date June 2006
    Journal Current Sports Medicine Reports
    Title Epidemiology of Stress Fractures.
    Date April 2006
    Journal Clinics in Sports Medicine
    Excerpt

    Stress fractures are a frequent cause of injury in competitive and recreational athletes. Although a number of epidemiologic studies have been conducted, the populations studied and data collection methods have varied. This article presents an overview of injury epidemiology and reviews the current body of literature regarding the occurrence of stress fractures in athletes. Given the heterogeneity of the populations studied and the variations in data collection, few broad conclusions can be drawn. There is a pressing need for large prospective studies to better establish the risks of stress fracture by sport, age, and gender.

    Title Pharmacologic Agents in Fracture Healing.
    Date April 2006
    Journal Clinics in Sports Medicine
    Excerpt

    Bone fractures are a known risk of athletic participation and can result in significant lost playing time. A variety of medications have been investigated in animal studies regarding their effects on fracture healing. Parathyroid hormone and the bisphosphonates may have future uses in the prevention and treatment of athletic-related stress fractures and acute fractures. Nonsteroidal anti-inflammatory drugs have been implicated in effecting fracture healing in some animal models, but little clinical evidence supports these findings. Large randomized clinical trials are needed to further delineate the role of these and other drugs and their effects on fracture healing.

    Title Shoulder Impingement Syndrome.
    Date May 2005
    Journal The American Journal of Medicine
    Excerpt

    Subacromial impingement syndrome is a common cause of shoulder pain. The purpose of this article is to review the clinical presentation, physical examination findings, and differential diagnosis of impingement syndrome. Using an evidence-based approach, we propose an algorithm for the management of subacromial impingement syndrome including indications for nonoperative management, advanced imaging, and operative management.

    Title Bilateral Inguinal Lymphadenitis in a 7-week-old Infant.
    Date January 2000
    Journal Pediatric Emergency Care
    Title Sitting at the Top of the Slope.
    Date July 1998
    Journal Archives of Pediatrics & Adolescent Medicine
    Title An Unusual Scalp Lesion in a 15-year-old Girl: A Case Report.
    Date
    Journal Journal of Athletic Training
    Excerpt

    OBJECTIVE: To present an unusual congenital malformation of the central nervous system. BACKGROUND: Neural tube defects (NTDs) are potentially serious congenital malformations. When undiagnosed in childhood, such lesions may later be mistaken for a variety of other soft tissue abnormalities. Athletic trainers should be aware of the clinical findings associated with NTDs and the potential for infection in the event of an injury, thus ensuring proper treatment for injured athletes and referral of any athletes with suspicious lesions. DIFFERENTIAL DIAGNOSIS: Atretic meningocele, hemangioma, lipoma, sebaceous nevus, dermoid cyst, scar tissue, aplasia cutis congenita, and hematoma. TREATMENT: The consulting pediatric neurosurgeon thought that repairing the atretic meningocele was only necessary if symptoms recurred and persisted. This young woman is at increased risk for having a child with an NTD and will benefit from high doses of folic acid early in a future pregnancy. UNIQUENESS: Typically, NTDs are diagnosed in infancy or early childhood. This case represents a young woman whose NTD was not properly diagnosed until adolescence. In addition, NTDs can be mistaken for a variety of other skin lesions. The location and appearance of an NTD are typically distinctive to the knowledgeable examiner. CONCLUSIONS: Although NTDs are unusual, athletic trainers should be aware of such pathologic conditions to avoid mistaking these lesions for traumatic sequelae and to identify those athletes who may need further evaluation to rule out a potentially serious condition.

    Title A Review of Sudden Cardiac Death in Young Athletes and Strategies for Preparticipation Cardiovascular Screening.
    Date
    Journal Journal of Athletic Training
    Excerpt

    OBJECTIVES: To provide the reader with an overview of the many causes of sudden cardiac death in young athletes and to present various strategies for preparticipation cardiovascular screening. DATA SOURCE: A MEDLINE search using the phrase sudden cardiac death and the key word athlete for the years 1980 to 2000. DATA SYNTHESIS: Sudden cardiac death is a rare event in athletics. More than 20 different causes have been described, but most cases result from a few distinct entities. Most afflicted athletes have no symptoms before death. Many attempts have been made to detect those at risk for sudden cardiac death before athletic participation. At this time, a thorough history and physical examination are the most efficient screening methods for detecting cardiovascular abnormalities. Studies show that the current status of preparticipation cardiovascular screening of high school and college athletes nationwide is poor. CONCLUSIONS AND RECOMMENDATIONS: The use of diagnostic tests to screen for cardiovascular abnormalities is ineffective and inefficient. The most prudent and effective methods of preparticipation screening for cardiovascular abnormalities at this time are a history and physical examination in accordance with the American Heart Association guidelines. Athletic trainers must ensure that their institutions comply with these minimum standards.

    Title Seeing the Forest Through the Wheeze: A Case-study Approach to Diagnosing Paradoxical Vocal-cord Dysfunction.
    Date
    Journal Journal of Athletic Training
    Excerpt

    OBJECTIVE: To present for discussion a case of paradoxical vocal-cord dysfunction (PVCD), an uncommon disorder that may be misdiagnosed as, or coexist with, exercise-induced asthma (EIA). BACKGROUND: Vocal-cord dysfunction results from paradoxical closure of the vocal cords during the inspiratory phase of respiration and may be mistaken for EIA, resulting in unnecessary medical treatment and a delay in diagnosis. Although PVCD is uncommon, athletic trainers should be aware of the disorder, as they may play an important role in its diagnosis and treatment. DIFFERENTIAL DIAGNOSIS: Exercise-induced asthma, foreign body aspiration, anaphylactic laryngeal edema, bilateral vocal cord paralysis, extrinsic airway compression, laryngomalacia, subglottic stenosis, traumatic edema, or hemorrhage. UNIQUENESS: This case report describes a common presentation of an unusual disorder. By obtaining a detailed history from the athlete and having a high index of suspicion for the disease, we were able to diagnose PVCD, discontinue all EIA medications, and begin treatment. CONCLUSIONS: The athletic trainer can play a valuable role in the diagnosis of PVCD, which must be considered in the differential diagnosis for any athlete who is compliant with the medications prescribed for the treatment of EIA yet shows little or no improvement in symptoms. A high index of suspicion for PVCD will greatly aid health care professionals assessing the athlete.

    Title An Overview Of The Physiology And Pharmacology Of Aspirin And Nonsteroidal Anti-inflammatory Drugs.
    Date
    Journal Journal of Athletic Training
    Excerpt

    In this article, I present an overview of the actions and effects of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Although athletic trainers cannot prescribe or dispense prescription medications, they should be as aware of their effects as they are of other methods of injury treatment. To set the discussion in proper perspective, the inflammatory process and its mediators are reviewed briefly. The eicosanoids are a family of very active chemicals, which include: the prostaglandins, thromboxane, and the leukotrienes. They affect inflammation as well as numerous other body processes. Ingesting aspirin and NSAIDs blocks the production of prostaglandins and thromboxane, resulting in desired and undesired effects. The NSAIDs were developed to have the same action as aspirin, but with fewer adverse side effects. Many NSAIDs are currently available, and the decision as to which agent to use depends upon various factors. Surprisingly, recent studies suggest that some NSAIDs may hinder the healing process. Although not a NSAID, acetaminophen has many important clinical uses. Armed with an understanding of how these drugs act, and their potentially harmful aspects, the athletic trainer can assist the team physician in designing an aspirin- or NSAID-therapy regimen.

    Title Refocusing the Adolescent Preparticipation Physical Evaluation Toward Preventive Health Care.
    Date
    Journal Journal of Athletic Training
    Excerpt

    The traditional preparticipation physical evaluation has come under much scrutiny by sports medicine physicians in recent years, following a number of studies that have found it to be of low yield and not cost effective. There is a general consensus among these researchers that a refocused preparticipation physical evaluation presents an excellent opportunity for health education. In this article, I review recent research that shows that the traditional "head-to-toe" physical exam is unnecessary and is more effectively replaced by a detailed history and focused physical exam. I present current epidemiologic and sociologic data that is pertinent to all health care professionals working with adolescents. Various methods to uncover potential problem areas in the young athletes' lives are also discussed. Each format may be adapted to local or community standards and needs. The approach to the preparticipation physical evaluation presented in the article allows athletic trainers to have an active role in the most important aspect of health care: the prevention of disease and injury.

    Title Initial Evaluation and Management of Acute Scrotal Pain.
    Date
    Journal Journal of Athletic Training
    Excerpt

    OBJECTIVE: To provide the reader with the background knowledge to ensure a prompt and proper initial evaluation of the athlete with acute scrotal pain. DATA SOURCES: A MEDLINE search was conducted using the key words "scrotum" and "pain" for the years 1980 to 1999. DATA SYNTHESIS: The 4 most common causes of acute scrotal pain in athletes are trauma, testicular torsion, torsion of a testicular appendage, and epididymitis. Although all can appear clinically similar, subtle features in the history and physical examination may lead the examiner to the correct diagnosis. However, physician evaluation is essential, and diagnostic imaging or surgery may be required for a definitive diagnosis and to avoid loss of the testicle. CONCLUSIONS AND RECOMMENDATIONS: Although acute scrotal pain is a rare occurrence, it is important for the athletic trainer to recognize the common causes of the condition. An understanding of normal scrotal anatomy and the pathology of scrotal trauma, testicular torsion, torsion of a testicular appendage, and epididymitis are essential to provide a prompt initial evaluation and appropriate referral.

    Title Youth Sports: A Pediatrician's Perspective on Coaching and Injury Prevention.
    Date
    Journal Journal of Athletic Training
    Excerpt

    OBJECTIVE: My objective is to review the factors that influence youth participation in sports, to discuss the role coaches may play in youth sports injuries, and to call on athletic trainers and other health professionals to become involved in youth sports in an effort to limit injury risk. BACKGROUND: Millions of American youths participate in team sports. Their primary motivation to participate is to have fun. Unfortunately, large numbers of participants have sustained correspondingly large numbers of injuries. Many injuries can be attributed to improper technique and conditioning methods taught by volunteer coaches. Although not the only contributors to injuries, these may be the most amenable to preventive measures, such as formal instruction for coaches in the areas of proper biomechanics and player-coach communication. DESCRIPTION: I provide an overview of the reasons why children participate in sports, discuss participation motivation, and review the literature on coaches' communication methods that have been proved effective in maximizing learning and enjoyment for young athletes. CLINICAL ADVANTAGES: This article provides certified athletic trainers with the background knowledge needed to take an active role in youth sports injury prevention at the community level.

    Title Online Training in Sports Concussion for Youth Sports Coaches.
    Date
    Journal International Journal of Sports Science & Coaching
    Excerpt

    The purpose of this study was to evaluate ACTive: Athletic Concussion Training using Interactive Video Education, an interactive e-learning program designed to train community coaches of youth ages 10-18 in effective sports concussion prevention and management practices. Seventy-five youth sports coaches from across the country completed the study over the Internet. Results of a randomized control trial demonstrated significant differences between treatment and control participants on measures of (a) knowledge about sports concussion, management, and prevention; (b) attitudes about the importance of preventing sports concussion; and (c) intention and self-efficacy in sports concussion management and prevention. The results suggest that ACTive is an effective method of training youth sports coaches who are in an important position to reduce risks associated with sports concussion.


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