I recently framed ten large medals, which the customer earned for running marathons. They were large and heavy, with fabric neck straps attached.
The medals were mounted in two rows of five, with clear film straps, to a piece of 4-ply matboard. The fabric straps of the bottom row's medals were pulled through a horizontal slot to the back of the board. The top row's fabric straps were folded over the top edge of the mount board. All were secured to the back with clear film jackets, taped in place.
A top mat was cut with two rectangular openings that show the medals and about 2" of the fabric straps. Also, a 1/2" x 2" caption opening was cut under each medal, for the marathon's date & time. The band of mat across the middle, between the two openings, covers the straps' slot in the board. Spacers under the top mat accommodated the medals' thickness.