Among the hundreds of sexual-abuse sufferers of the former U.S.A. Gymnastics doctor Lawrence G. Nassar, the ones who have got the most attention have been brand-name Olympians, such as McKayla Maroney, Aly Raisman and Simone Biles, and those who say their abuse dates back to especially young ages — 12, 9, even 6.
But a subset of the more than 256 reported sufferers whom the Michigan attorney general’s office counted last week were Michigan State athletes at the time they say they were abused. Their stories give a stark window into how Dr. Nassar was able to capitalize on his status and reputation, the credibility of his university and even the essential pressure of college sports to exploit adult women even after questions about his plan had been raised.
The Michigan State athletes, who were conditioned to compete and proudly represent the Spartans against N.C.A.A. rivals and on national stages, say they are still arriving to terms with what many said was the university’s negligence in enabling a predator.
“You suppose you’re going to get the best, because they want the best out of you,” said Natalie Stein, a distance runner from the Los Angeles area who said Dr. Nassar twice performed a “mild” version of his distinctive intravaginal massage treatment on her in the spring of 2004.
“It’s a high-pressure situation, running for that kind of school,” Stein said. “You need to please your coaches. You want to display that you’re doing everything you can to get better. You’ll try anything to get better, so you don’t question things.”
Roughly a dozen women who say they were molested while they were Michigan State athletes have been publicly identified, though more than that exists, according to interviews with several of them. Active members of the volleyball team were abused by Dr. Nassar, the team said in a statement. These victims do not necessarily acquire a special legal status, although they will likely be at the center of an N.C.A.A. investigation into whether the university jeopardized their welfare.
In a statement, Michigan State admitted no failures by the university but promised compelling changes.
“President Engler has called for a culture change at M.S.U.,” a university agent said in an email, referring to the school’s interim president, the former Michigan governor John Engler, “and we will be taking all necessary steps to start a new day and improve the environment at the university.”
In many cases, the athletes’ abuse took the form of the treatment Dr. Nassar used for so many ailments: a pelvic massage in which he inserted his fingers into his patients. Medical professionals who perform a similar process are supposed to use a glove or lubricant; someone else is supposed to be current observing; and the doctor is supposed to explain the process in detail before he starts. According to court testimony, Dr. Nassar often followed none of those protocols.
The Michigan State athletes said they supposed their university — a Big Ten member that spent more than $120 million on its 23 varsity teams last year, per USA Today’s database — was providing strict oversight of their care and the people who conducted it.
On many afternoons at Michigan State’s Jenison Field House, several athletes — volleyball players, rowers, runners and others, male and female — lined up like theatergoers at a box office, waiting for a daily window of medical office hours for athletes to open at 5 p.m. Sometimes the doctor on duty was Nassar, who was the physician for the women’s gymnastics and rowing teams, and who was known broadly for his unorthodox methods.
“I remember it as being common knowledge — everybody knew if you went to him, you got weird treatment,” said Stein, who found herself before Dr. Nassar one afternoon easily because he happened to be on call when she sought medical care.
“I believed in the fact that I was at a top program, a top Division I school,” added Cate Hannum, a rower who said Dr. Nassar regularly massaged her breasts under the pretext of medical treatment during some of her years at Michigan State. “Why wouldn’t they have the best of the best?”
Several athletes said they observed ways in which Dr. Nassar made students reliant upon him. Charla Burill, a runner, described his diagnosis of a fracture in her sitting bones as a “godsend” after other doctors failed to find what was causing her pain.
Lindsey Lemke — a gymnast who said Dr. Nassar abused her starting in junior high school and, after she became a Michigan State athlete, on one occasion administered acupuncture in her pubic area — recalled his saying, “I do this to Olympians, to a lot of people.”
His reputation as doctor to the national gymnastics team anticipated him.
“Even my parents, they never did anything about it,” said Christie Achenbach, a runner who said she discussed Dr. Nassar’s vaginal procedure with her parents and her coach at Michigan State. “You know, ‘He’s a doctor’ — not just a doctor, the Olympic gymnast doctor.”
When Achenbach told her teammates, she said, “They didn’t think it was out of the ordinary, and I thought maybe it was me overreacting.”
An investigation conducted last year by a lawyer for Michigan State cleared university officials, but the details of that investigation have not been made public. A Title IX investigation in 2014 did not charge Dr. Nassar with violations, but the integrity of that inquiry has recently been called into question by newly released public documents.
Michigan’s attorney general has said he plans a new, independent investigation in the wake of reports and accusations that Michigan State officials and coaches were told of Dr. Nassar’s behavior years before it became public, yet did nothing to stop him from treating athletes.
The former gymnastics coach Kathie Klages learned of Dr. Nassar’s behavior as early as 1997, according to reports based on public documents. As late as the end of 2016, Lemke said she told Klages — her coach at the time — about her experience with Dr. Nassar, after an article about the allegation against him arrived in The Indianapolis Star. Klages’s response then, Lemke recalled, was to upbraid her and warn her against spreading false information.
A lawyer representing Klages in civil lawsuits rejected to comment.
Achenbach received an athletic scholarship to run the mile for Michigan State in 1996. She said she visited Dr. Nassar in 1999 for an injury to her right hamstring.
“He said it was going to be a unique process,” she said, “but he said he’d had good results with it.”
With no one else in the room, and without wearing a glove, Achenbach said Dr. Nassar rubbed her vagina and then inserted his fingers and manipulated her pelvic bone.
“I guess that was supposed to cure my hamstring,” she said.
Like Achenbach, Hannum was recruited to Michigan State. Growing up in Andover, Mass., she had aspired to be an Olympic rower. At the time, Michigan State was a top-10 program. Beginning in high school, though, she said she experienced pain in her chest. It was later found to be thoracic outlet syndrome, in which blood vessels near the collarbone constrict. (Mets pitcher Matt Harvey has had the same issue.) Hannum had two surgeries to correct the issue, and Dr. Nassar treated her afterward, including after he disqualified her from competing for medical reasons.
Hannum said Dr. Nassar would tell her she had popped a rib, then he would reach under her sports bra and massage her breasts. One time, she said, she noticed that he arrived to be physically aroused.
Other physicians Hannum saw found the notion that she had a popped rib dubious. “Any time I would say that to another doctor, like when I was home, they would say, ‘That doesn’t make any sense,’” she said. “I’d say, ‘Well, it’s Dr. Nassar, he’s an Olympic doctor.’”
All the athletes interviewed for this article said they tolerated Dr. Nassar’s conduct in part because they did not realize how disproportionate it was, and because both he and, in a sense, the university, held a certain power over them.
“I had heard from other girls about his ‘special treatments,’” Hannum said. “At first it implied horrifying to me, but then I was told by my teammates that it was really uncomfortable to endure but an unfortunate thing they had to deal with and they didn’t want to talk about it.”
She added: “A lot of the student athletes said he was kind of odd and weird, but everybody said he was really the best — he would help me with my issue. What I didn’t realize through the whole experience is that I was really dependent on him. I required him to feel better.”