WASHINGTON (WASHINGTON POST) - The 17-year-old girl told police that, after their first appointment in 2004, the sports physician asked her for a hug, which she found unusual, and when she returned a few months later he said, "I bet people at physical therapy don't do this," as he began to massage her.

Then, without warning, the physician slid his bare hand into her underwear and pressed hard in sensitive areas, the girl told police, before massaging her breasts. She wanted him arrested.

When the physician - Larry Nassar, of Olympic gymnastics fame - came to the police station a few days later, he admitted he touched the girl between her legs, but explained it as a legitimate medical technique.

He brought a PowerPoint presentation, and after the officers reviewed it, one of them called the girl's mother to tell her there would be no arrest.

A local police force in suburban Lansing, Michigan, released for the first time on Wednesday (Jan 31) a 2004 report that details a missed opportunity to stop Nassar, the disgraced former Michigan State University and USA Gymnastics women's team physician, more than 12 years before he was finally arrested after another woman went to police, and then to a newspaper, with a similar account.

The 50-page report, which contains a black-and-white copy of Nassar's PowerPoint presentation, offers a glimpse of some reasons why Nassar escaped detection for so long: Police officers who failed to ask the right questions or seek out experts encountered an audacious perpetrator who masked his abuse as medicine.

The report was released the same day the Michigan Attorney General's Office updated the number of girls and women who have filed complaints with law enforcement asserting abuse by Nassar - the figure is now 256, up from 156 just last week, and is expected to rise.

"We missed it. We're not going to hide it. We were deceived," said Frank Walsh, Meridian Township Manager, in a news release.

On Thursday, Meridian Township plans to apologise formally during a news conference to Brianne Randall-Gay, the woman who, as a 17-year-old in nearby Haslett, Michigan, sought treatment from Nassar for pain associated with scoliosis.

Randall-Gay declined to comment Wednesday.

"I remember fearing that no one would believe me," she said earlier this month in her victim's impact statement during Nassar's sentencing hearing, which ended with a judge sentencing the 54-year-old to 40 to 175 years in prison. "This fear became a reality."

On Randall-Gay's first appointment with Nassar at the Michigan State sports medicine clinic, in the summer of 2004, he didn't touch her improperly, she later told police. Her mother was there, and so was a medical student.

Nassar performed strength and flexibility tests, then recommended a few visits with physical therapists. The only thing she found odd about her first appointment, Randall-Gay said, was the request for a hug at the end from the then-39-year-old physician.

A few months later, in September 2004, Randall-Gay returned to Nassar for a follow-up visit. This time, her mother wasn't there, and Nassar treated her alone.

He told her she had some tightness in her back, gave her a gown and shorts with Velcro straps to change into, and then asked her to lay on her stomach.

Nassar massaged her back, Randall-Gay later told police, before he told her, "This might give you a wedgie," as he undid the Velcro straps to her shorts and pulled her underwear to the side.

For about 20 minutes, she said, Nassar pressed hard in her "crotch area," explaining, as he touched her, that this would relieve tension in her back.

Nassar then spent about 10 or 15 minutes massaging and squeezing her breasts, she said, while explaining this also would relieve tension in her back. When he finished, Nassar took some notes on a clipboard, and then told her he'd turn around while she put her clothes back on.

The next day, Randall-Gay walked into the police station in Meridian Township, with her mother, and filed a complaint.

"Randall stated that she was 'scared' and 'uncomfortable' while Nassar was touching her . . . She thought it was 'weird' and it 'freaked her out,'" an officer wrote. "She didn't know if it was possible that this type of touching was normal in this type of doctor visit."

Police sent Randall-Gay to a local hospital, where she met with a registered nurse in charge of a sexual assault program who performed an examination.

The results of that examination are unclear from the report, and there is no documentation stating whether the nurse offered any commentary to police about the legitimacy of the techniques Randall-Gay described.

Two weeks later, Nassar agreed to an interview with police, and explained there must have been a misunderstanding. He had been massaging the sacrotuberous ligament, he told police, which runs through the pelvic region and, when pressured, can relieve pain in the lower back and upper legs.

Nassar gave them a PowerPoint presentation he'd prepared, complete with pictures of him performing the treatment on other patients.

Nassar offered no explanation for massaging the girl's breasts, and the report contains no information suggesting officers asked for specific answers on that point.

Shortly after this interview, one of the officers called Randall-Gay's mother to tell her Nassar would not be charged with a crime, because he had been providing legitimate treatment.

Randall-Gay's mother expressed concern that Nassar hadn't warned her daughter where he was going to touch her or worn gloves, and also was bothered he'd done this without anyone else in the room, the report states.

The officer told the mother he'd pass those concerns along to Nassar. "The doctor was using a medically accepted technique for the alleviation of pain. No crime was committed," the report's conclusion states.

Massaging of the sacrotuberous ligament is a commonly accepted practice for pain relief in osteopathic medicine, chiropractic treatment and massage therapy, experts said, but should never be performed on a minor without first explaining the treatment to both the child and a parent and getting permission, potentially in writing.

When performing this treatment, experts advise wearing gloves or massaging over clothing, because the ligament is in a sensitive area, near the anus and genitals.

"Because it's a personal area, you should use a lot of caution," said Til Luchau, an advanced rolfer - a practitioner of alternative medicine based on deep tissue massage - who has performed the procedure for more than 30 years.

Luchau reviewed Nassar's PowerPoint presentation for The Post, and stopped on photographs Nassar included, in which he is touching his patients, between their legs, with bare hands.

"That is not at all common," Luchau said. "It is reprehensible, what he did." It does not appear, from the report, that Meridian police contacted any medical experts.

A decade later - in 2014 - a recent Michigan State graduate made a similar complaint about Nassar to both university police and the school's Title IX office.

Again, Nassar asserted the woman misunderstood legitimate treatment, and both investigations cleared him.

In August 2016, another woman filed a complaint with Michigan State police and then told her story to the Indianapolis Star, prompting dozens of women across the country to realise they also had been assaulted by Nassar, and the police investigation that ultimately brought about his conviction.

In her statement during Nassar's sentencing hearing, Randall-Gay recalled that her assault occurred during a particularly stressful time - her father was dying of cancer - and left her suffering from anxiety.

Over the years, she said, she never doubted that she had been a victim of sexual abuse, but she had hoped that, by filing a police report, she had scared Nassar enough that he'd never do it again.

"For 13 years, I wondered if I was the only one," she told Nassar in court in the second day of his sentencing hearing, her statement the 26th of 156 that would eventually be read, "or if there were others."