Judge Janice Cunningham cited Nassar's earlier claims of no wrongdoing and said that he was in "denial". The Eaton County charges were related to incidents at Twistars, an elite gymnastics club run by John Geddert.
More than 260 women and girls say they were assaulted by Nassar, including 2012 Olympic teammates Aly Raisman, Jordyn Wieber and McKayla Maroney. "It spans the country and the world".
Before his sentencing, Nassar offered one final apology to his victims, reciting with no emotion what sounded like the same statement he read in Ingham County Circuit Court on January 24. They said Geddert's coaching style of demanding obedience via intimidation gave Nassar an opportunity to exploit gymnasts by playing the "good cop" role. Overall, he is accused of molesting an estimated 265 young women and girls during his two-decade career.
USA Gymnastics cut ties with Nassar in 2015, while a story by local newspaper the Indianapolis Star published two victims' allegations in September 2016.
The last of the three sentences was handed down Monday over abuse Nassar committed at the Twistars gymnastics training centre in MI. The sentence calls for Nassar to serve a minimum of 40 years in prison. Sheriff's deputies tackled him before he reached the former doctor.
Assistant Attorney General Angela Povilaitis used a portion of her closing argument Monday at Nassar's sentencing hearing to speak about people questioning parents' role in not detecting Nassar's sexual assaults under the guise of medical treatment.
As Nassar was being escorted out of the courtroom in handcuffs, Cunningham said, "Ladies and gentlemen, this now ends the criminal legal proceedings involving Larry Nassar". Investigations into the disgraced doctor's misconduct will go on long after he's locked up in a federal prison.
"We are very sorry that any athlete has been hurt by the despicable crimes Larry Nassar committed", the statement reads in part.
The heated atmosphere over the past few weeks culminated Friday when Randall Margraves, a father of three victims, tried to attack Nassar in open court.
Even before Monday, it was clear that the 54-year-old former doctor never would be free again. He worked for Michigan State University and USA Gymnastics, which trains Olympians.