Which patient would benefit least from active shoulder flexion in the supine position without weights?

• A. Two weeks status post rotator cuff repair
• B. Severe pain when performing standing shoulder flexion
• C. Active cancer near the shoulder joint
• D. Severely deconditioned

Answer: (C)

The key idea is safety and tissue tolerance when starting active shoulder motion. Active flexion in the supine position places force through the shoulder structures, so any condition that weakens bones or tissues near the joint or risks spread of disease changes the risk/benefit balance.

Active cancer near the shoulder joint is a red flag because metastasis or bone lesions can weaken the bone and surrounding tissues. Even gentle active movement could precipitate a pathological fracture, collapse of the area, or spread of cancer cells, making this scenario the least suitable for initiating active flexion without medical clearance and oncologic input.

The other scenarios present healing or pain considerations that professionals manage with staged progression or pain-guided activity, but they do not carry the same broad safety concerns about initiating movement as a joint with active cancer.