You Begin a Lower Extremity Strengthening Program with a 30-Year-Old

You begin a lower extremity strengthening program with a 30-year-old woman. During the first session, she begins to complain of anterior knee pain that she says occurs only when she is performing a squat exercise. She has no previous history of knee pain. Which of the following is not an appropriate change to make in her training?

A) instruct the patient to perform the squat into increasing knee flexion angles, educating her that the squat exercise will be less painful if she moves through a larger range of motion
B) modify the squat so she is performing the exercise only through the range of 0 to 45 degrees of knee flexion, which she finds is pain-free
C) discontinue the squat exercise and substitute another lower extremity strengthening exercise that does not cause pain
D) correct body mechanics during the squat, including cuing to decrease knee valgus motion, and reassess if pain continues to occur during the exercise. Continue the exercise only if there is no pain