Nassar Coverage

Nassar laid out treatment guidelines in medical textbook in 2004

WLNS - Former MSU and USA gymnastics doctor Larry Nassar was a prominent figure in the gymnastics community, highly regarded for his ability to treat athletes.

He's now behind bars, accused of failing to follow his own advice when it came to performing a sensitive medical technique, one he wrote about in 2004.

"Take special measures to explain any examinations and techniques applied in this region, including appropriate draping, presence of a chaperone or another clinician, and warning in advance what you are planning to do."

That's what Nassar wrote in a textbook about sports medicine when describing how to treat a patient in their sensitive area.

Their sensitive area, described by him as the "no-fly zone," is considered to be the proximity of a persons genitalia and buttocks.

Ten years later, he would become subject to similar restrictions placed upon him as a result of an investigation at Michigan State University.

The book, called "Principles of Manual Sports Medicine" is a compilation of more than 100 illustrations that offers step-by-step presentations to help assure proper technique in a variety of different sports when it comes to medical practice.

Nassar's contribution to the book is focused on the use of manipulative medicine in the sport of gymnastics. It details everything from common areas for injury, to techniques when it comes to treatment.

Nassar faces criminal charges on both the state and federal levels.

Prosecutors charged him with more than 20 counts of criminal sexual conduct in the first degree. He also faces child pornography charges after investigators found nearly 37,000 images on his property.

Nearly 50 women and girls have filed lawsuits against him, alleging the doctor sexually abused them during treatments.

Nassar has maintained his innocence in both state and federal court and says the treatments he performed on his patients were accepted medical techniques.

In fact, in his contribution to "Principals of Manual Sports Medicine," Nassar describes the medical technique.

He says it's a form of medical treatment to assess injuries for gymnasts.  Part of that assessment requires the doctor to touch the "no-fly zone area" and Nassar even says, the process could require a "rectal examination."

It details the physical examination to assess the "sacrotuberous ligament" which is part of the pelvis.

According to a medical dictionary, the sacrotuberous ligament serves as a bridge between the ankle and shoulder.

Nassar wrote: "The clinician then reaches with the thumbs into the ischial rectal fossa area to position them inferior to the sacrotuberous ligament."

Nassar himself also laid out strict, professional guidelines before doing this treatment, that more than a dozen of his patients are accusing him of not following.

"Gymnasts frequently land on their buttocks with great force, usually unintentionally; this causes stress on the coccyx, pelvis diaphragm, and sacrotuberous and other sacroiliac ligaments," it says. "These repetitive hard landings on the buttocks lead to significant dysfunction in the pelvis."

It goes on to say that the area of the body in these young females is often not examined because of the proximity of the "no fly zone."

"However, it is only with thorough examination of the pelvic structures of the gymnast that dysfunction is found and proper treatment can be applied to resolve the symptoms," it says.

It goes on to say, "Take special measures to explain any examinations and techniques applied in this region, including appropriate draping, presence of a chaperone or another clinician, and warning in advance what you are planning to do."

According to a number of lawsuits and an affidavit, Nassar sexually assaulted young women and girls at Twistars Gymnastics and at his home in Holt.

Many of Nassar's accusers say he didn't wear gloves while performing the treatments and didn't ask for consent before doing it.

In 2014, Nassar was subject to new regulations set forth by the MSU Dean of Osteopathic Medicine, Dr. William Strampel.

According to MSU, this was a result of an investigation into Nassar, after a patient raised concerns over the treatment she was receiving by Dr. Nassar.

On July 30, 2014, Dr. William Strampel emailed Dr. Nassar saying the following:

  • "We will have another person, (resident, nurse, etc.) in the room whenever we are approaching a patient to perform procedures of anything close to a sensitive area.
  • The procedure which caused the patient emotional distress because of her interpretation will be modified in the future to be sure that there is little to no skin to skin contact when in these regions. Should this be absolutely necessary, the procedure will be explained in detail with another person in the room for both the explanation and the procedure
  • New people in our practice will be oriented to be sure they understand these requirements.

Jason Cody, a spokesperson for the university, said that when Nassar was given those guidelines, put into place by his supervisor in 2014, he was expected to follow them.

He said when the university found out in September 2016 that Nassar didn't follow those guidelines, MSU fired him.

In a letter to Nassar terminating his employment in 2016, Suresh Mukherji, chairman of the Department of Radiology, and Dr. Strampel, wrote that Nassar had admitted not always following the procedures set out in the 2014 restrictions.

According to MSU Police, to date, the department has received more than 90 complaints against Nassar.

The former doctor is due back in court the second week of May.

More Stories

Meet the Team

Don't Miss

Latest News - Local