Pain guide · Knee pain

Knee pain when doing deadlifts: the bar path and shins, conventional, sumo and Romanian deadlifts

Knee pain when you deadlift usually comes from the set-up or the style rather than from the deadlift itself, which asks less of the knee than a squat. Starting with the hips too low bends the knees further, a bar that drifts or drags scrapes the shins and kneecaps, a wide sumo stance with the knees caving in loads the inner knee, and snapping the knees back in stiff-legged or Romanian pulls strains the back of the knee. Where it hurts is the best clue: around the kneecap points to kneecap pain, one point below or above it to a tendon, the inner knee in sumo to the inner knee tendons, and the back of the knee to the hamstring tendons or a Baker's cyst. A higher start or a rack pull, the bar close with your shins protected, a stance your knees can follow and soft knees in Romanian deadlifts usually help. No study has counted knee pain from deadlifts, so this guide says where each piece of advice comes from.

This guide starts with the signs that need help, from accident and emergency (A&E) for a knee that changed shape or swelled fast after a pop, to a same-day check for a pop at the front of the knee with a knee you can't straighten, a hot, red swelling over a scraped kneecap or a swollen, painful calf, and advice from the National Health Service's 111 line (NHS 111) for a knee that locks, gives way or is hot and swollen with a fever. It then maps the causes by where it hurts, explains what the lab studies show about conventional, sumo, Romanian and trap bar deadlifts and why a scan rarely helps at first, shows how to change your deadlift today, and gives a three-stage plan with a 3D demo of every move, from hinge practice and rack pulls back to the bar from the floor.

3-stage exercise plan When to get help 37 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Go to A&E if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape.
Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
Get advice from NHS 111 now: after a twist, your knee won't go fully straight, or something blocks the last part of straightening, even if you can still walk on it. A torn piece of meniscus caught in the joint can do this, and it needs checking promptly.
Same day: a pop or tearing feeling at the front of the knee after a fall, stumble, jump, landing or a heavy squat, then you can't straighten the knee or lift the straight leg off the bed, there's a dent above or below the kneecap, or the kneecap sits higher or lower than on the other side. Go to A&E or an urgent treatment centre, or get help from NHS 111. A torn quadriceps or patellar tendon does best when it's repaired soon.
Signs of a torn ligament: you felt or heard a pop, the whole knee swelled within a few hours, or it gives way, feels loose or bends further back than the other knee. Get it assessed promptly, the same or the next day: our ACL, PCL and outer knee ligament (LCL) guides explain what happens next.
You hurt your knee and cannot take 4 steps, or you are 55 or over and have injured it: get it checked the same day for a broken bone.
Get advice from NHS 111 now: a hot, red or swollen knee with sudden severe pain, a very high temperature (although not everyone has one), or feeling hot, cold or shivery. This can be a joint infection.
Same day: the swelling over or below the kneecap becomes hot, red or more painful, the skin over it is broken, or you have a high temperature or feel shivery, sick or unwell. Ask for an urgent GP appointment or call NHS 111: it may be infected and need antibiotics.
Call 999 or go to A&E if your child gets sudden pain in their hip, knee or thigh (hip problems can sometimes be felt in the thigh or knee) or cannot put any weight on their leg. If your child is limping, ask for an urgent GP appointment or get help from NHS 111 the same day. This applies to teenagers too, and in some children knee pain is the only sign.
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin; or swollen veins; or sudden worse pain and swelling around a lump at the back of the knee (a possible clot or a burst Baker's cyst).
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. Do not drive yourself. It can be a blood clot that has reached the lungs.
Get help from NHS 111 if you think you've injured your hamstring and it's very painful, or the pain is getting worse; there's a large amount of swelling or bruising, or the swelling or bruising is getting worse; it hurts to walk or stand using the injured leg; your leg feels very stiff or is difficult to move; it's not feeling any better after treating it yourself; or you have a very high temperature or you feel very hot, but also cold and shivery, which could be signs of an infection.
Call 999 or go to A&E: back or leg symptoms with numbness around the genitals or bottom, new trouble controlling your bladder or bowels, or severe or worsening weakness or numbness in both legs.

See a doctor or physiotherapist if

Knee pain that has not improved within a few weeks of looking after it at home. Many areas offer NHS physiotherapy without a GP referral.
Kneecap pain that hasn't improved within 6 weeks of changing your activities and doing the exercises, or that gets worse: talk to a GP or physiotherapist.
The knee gives way, the whole knee swells, or it catches or locks: that isn't typical of kneecap or tendon pain. Get it checked for a ligament or meniscus injury (our suggestion).
Catching, locking or swelling at the joint line that hasn't settled after about 3 months of exercise and other non-surgical care: ask your GP or physiotherapist about a specialist review. A magnetic resonance imaging (MRI) scan may be considered then.
Tendon pain above or below the kneecap and you take steroid tablets or have steroid injections, use anabolic steroids, have kidney disease, gout, rheumatoid arthritis, lupus or diabetes, or have recently taken a fluoroquinolone antibiotic: tell your GP or physiotherapist and build up more gradually. These can weaken the tendon. If you're taking a fluoroquinolone now, stop taking it and contact your doctor straight away, as the UK medicines regulator advises.
Bursitis that hasn't improved, or is getting worse, after 1 to 2 weeks of looking after it yourself, a knee you can't move, or very severe, sharp or shooting pains: see a GP.
A lump anywhere on your body and you don't know what it is, or a lump that is solid, painless, hard to move and keeps growing. Get it checked by a GP.
Calf pain or cramps during exercise with tingling in the foot, often in both legs, in a young athlete: ask about popliteal artery entrapment, a rare problem with the artery behind the knee.
A child or teenager with pain at a bump just below the kneecap or at its lower tip, worse with squats, jumps and kneeling: see our Osgood-Schlatter and Sinding-Larsen-Johansson guides, and get it checked if it is getting worse.
Numbness, tingling or weakness that travels down the leg from the back. That points to a nerve (sciatica) rather than the knee.
Swelling in several joints, or morning stiffness that lasts more than 30 minutes: see a GP. It can be an inflammatory arthritis such as rheumatoid arthritis rather than osteoarthritis.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The front of the shins or over the kneecaps, scraped, bruised or bleeding

The bar dragging up your legs: it's meant to stay close, so protect your shins with long socks or soft shin guards (our suggestion) and clean any cuts.

A swelling over or just below the kneecap, sometimes warm, after scrapes or kneeling

Bursitis in front of the kneecap. A hot, red swelling or broken skin needs a same-day check, as the warning signs say.

Read: Knee bursitis →Around or behind the kneecap, hard to point to, at the start of the pull or after sitting

Usually kneecap pain (patellofemoral pain), also worse on stairs and squatting. A higher start usually helps (our reading).

Read: Runner's knee →One point at the lower tip of the kneecap

Usually patellar tendon pain (jumper's knee), worse with jumping and heavy knee work.

Read: Jumper's knee →One point at the top edge of the kneecap

Possibly quadriceps tendon pain.

Read: Quadriceps tendinopathy →The inner knee a few centimetres below the joint, worse in a wide sumo stance

Often the inner knee tendons and bursa (pes anserine), the commonest problem of the hamstring tendons at the knee. Sumo puts more side-to-side load through the knee, so a narrower stance or a conventional pull usually helps (our reading).

Read: Pes anserine pain →The inner or outer joint line, with catching, locking or swelling later that day

Often a meniscus tear; from mid-life, usually a worn tear with no clear injury. A knee that locks needs checking.

Read: Meniscus tear →The back of the knee at the inner or outer corner, in Romanian or stiff-legged deadlifts

Usually the hamstring tendons at the knee. Shorten the range and keep your knees soft.

Read: Pain behind the knee →A soft lump behind the knee, worse after walking

Often a Baker's cyst. Sudden worse pain and swelling in the calf below it needs a same-day check.

Read: Baker's cyst →A sudden pain at the back of the thigh, sometimes just above the knee, then bruising

A hamstring strain, common in fast or heavy hinges.

Read: Hamstring strain →The knee snapped back past straight at the top, then pain, swelling or a loose feeling

A hyperextension injury: read the warning signs first.

Read: Hyperextended knee →A pop at the front of the knee, then you can't straighten it or lift the straight leg

A possible torn quadriceps or patellar tendon: get it checked the same day.

Read: Kneecap tendon rupture →A stiff ache in both knees from mid-life, worse getting going

Often knee arthritis, for which exercise is a core treatment.

Read: Knee arthritis →Achy thighs or hamstrings a day or two after a heavy session

Muscle soreness, which fades within days.

Read: Knee pain after a workout →The same knee pain in squats or on the leg press

The same causes. Our squat and leg press guides cover depth and a plan back.

Read: Knee pain when squatting →

Understand it

What a deadlift asks of the knee, and what no study has countedEmerging evidence

A deadlift lifts the bar from the floor by straightening the hips and knees together, and the hips do most of the work. In 28 trained adults, the deadlift's peak knee extensor moment was about half the back squat's (1.18 against 2.14 newton metres per kilogram) and the work done at the knee about a quarter. In 30 experienced men, both conventional and sumo pulls started with the knees well bent, and the knees straightened as the bar rose past them. In a conventional pull, the thigh muscles then switch from straightening the knee to resisting a bend as the bar travels up the thighs.

Sumo worked the front of the thigh harder early in the pull and added side-to-side load through the knee, with the knees angled out at the start. The trap (hexagonal) bar shifted load from the back and hips to the knee in 19 powerlifters, worked the front of the thigh harder in 20 men and bent the knees more in 11 women. The Romanian deadlift keeps the knees soft and fixed while the hamstrings, especially the inner one, do the work.

No study has measured the load on the kneecap or the patellar tendon in a deadlift, the bar against the shins, or locked knees, or counted knee pain from deadlifts. So the map on this page comes from what each cause is known to do.

Sources 1, 2, 3, 4, 5, 6, 7, 8, 9

Who gets itEmerging evidence

People new to the deadlift who set up too low or too far from the bar; lifters with sore kneecaps or tendons from squatting, jumping or running, whom the start of the pull or the trap bar provokes (our reading); sumo lifters whose knees cave in or whose stance is wider than their knees can follow; people who lock or snap their knees back in stiff-legged and Romanian pulls; and people who add load fast.

In powerlifting, the knee is a less common injury site than the lower back and shoulder, and less common than in weightlifting. One survey of 104 powerlifters linked current knee injuries with using lifting straps more often, which the authors could only speculate about. A US Army public health fact sheet says deadlift injuries are mostly to the knee and lower back, citing powerlifting reviews. No study gives the share of each cause in deadlifts. Serious causes are uncommon: a torn tendon, a locked knee, an infected bursa or joint and a clot are in the warning signs.

Sources 10, 11, 12, 13, 2

The back of the kneeEmerging evidence

Pain at the back of the knee usually comes from the soft tissues and tendons: the hamstrings, the calf and the popliteus. Semimembranosus tendon pain aches at the inner back corner just below the joint. Problems of the hamstring tendons at the knee are uncommon, pes anserine bursitis at the inner knee is the commonest of them, and most settle without surgery.

A Baker's cyst is a soft lump at the back of the knee that may be more visible standing and worse after walking. Pain or swelling in the leg that suddenly gets worse can be a burst cyst or a blood clot in a deep vein (deep vein thrombosis, DVT), which look alike and need a same-day check.

Sources 14, 15, 16, 17

When a scan helps, and what it can't tell youStrong evidence

Not at first for kneecap, tendon or inner knee pain, which are recognised by examination. In 991 adults aged 50 to 90, 61% of those with a meniscal tear on magnetic resonance imaging (MRI) had had no knee pain in the past month, and in knees without symptoms or injury, meniscal tears showed in about 10% and cartilage defects in about 24%, more with age.

Scans and tests matter for a knee that locks, a suspected quadriceps or patellar tendon tear, a fall or twist that meets the Ottawa knee rule (98.5% sensitive for fractures), a lump behind the knee or a swollen calf, and a hot, swollen knee or bursa, which may need fluid taken off and tested.

Sources 18, 20, 21, 22, 23, 24, 16, 19

How it usually goesMixed evidence

No study follows knee pain from deadlifts. The NHS says knee pain can often be treated at home and you should start to feel better in a few days, and to see a GP if it doesn't improve within a few weeks. Kneecap pain is often slower: of the 60 people who replied 5 to 8 years after two trials (of 310), 57% hadn't recovered well, though 48 of 50 had no arthritis on X-ray, and pain that had lasted longer at the start predicted a worse outcome. Patellar tendon pain improved over 24 weeks of loading in a trial. No one can promise a date.

Sources 25, 26, 27, 15

What helps, and how strong the evidence is

Deadlifts aren't bad for your kneesEmerging evidence

The deadlift asked about half the knee extensor moment of a back squat in 28 trained adults, and in powerlifting the knee is injured less often than the lower back or shoulder. Researchers who measured muscle activity in 13 football players suggested the deadlift's moderate to high co-contraction of the thigh muscles makes it a reasonable knee rehab exercise; that is their opinion, not a trial.

Sources 1, 10, 4

Conventional, sumo, Romanian and the trap barEmerging evidence

At a national championship, sumo lifters stood 70 cm wide against 32 cm with their feet turned out 42 against 14 degrees, and moved the bar a shorter distance. In 30 men, sumo added side-to-side load at the knee and loaded the front of the thigh more early; conventional pulls bent the hip more and worked the outer hamstring more. Sumo cut the modelled lower back load by about 10% in 57 powerlifters.

The trap bar lowered the peak loads at the lower back, hips and ankles and raised it at the knee in 19 powerlifters, worked the front of the thigh harder in 20 men and bent the knees more in 11 women. In 12 men, hamstring activity was highest in the Romanian deadlift. These are lab studies in healthy lifters; none measured knee pain. That the trap bar is a poor first choice while the kneecap or patellar tendon is sore is our reading of these knee-load studies.

Sources 3, 2, 28, 5, 6, 7, 8

Kneecap pain: exercise first, with the hips and knees togetherStrong evidence

A clinical practice guideline describes kneecap pain as pain around or behind the kneecap, worse with squatting, long sitting, stairs, jumping or running, which can come back and last for years. An international consensus supports exercise therapy, especially hip and knee exercises together, and doesn't recommend kneecap or lower back mobilisations on their own. Starting early matters, because longer pain at the start predicted a worse outcome years later.

Sources 18, 29, 26

Patellar tendon pain: progressive loading within 3 out of 10Strong evidence

In 76 people with patellar tendon pain, progressive tendon loading (holds, then slow strength work, then explosive and sport-specific exercises) beat painful eccentric decline squats at 24 weeks: 28 against 18 points on a 100-point tendon score, a difference of 9 points (95% confidence interval 1 to 16). Activities were kept at 3 out of 10 pain or less, and painful loading was cut for at least 4 weeks.

Source 27

A worn meniscus and knee arthritisStrong evidence

In 140 middle-aged adults with a worn meniscus tear, 12 weeks of supervised exercise matched keyhole surgery at 2 years, and 19% of the exercise group who later had surgery gained nothing extra. For knee arthritis, exercise eased pain by about 9 points out of 100 against placebo and 13 against no treatment across 139 trials (low certainty), and in 377 adults over 50, heavy strength training neither eased pain more than lighter training nor worsened it over 18 months.

Sources 30, 31, 32

Locked knees, straps and braces: what the fact sheet and surveys sayMixed evidence

A US Army public health fact sheet says that standing too quickly or fully locking the knees in stiff-legged pulls may increase damage to knee tissue or the hamstring, lists knees collapsing inwards as a fault, and says knee braces haven't been shown to prevent weight-training injuries. That is the fact sheet's statement, built on reviews and surveys, with no direct evidence behind it, and it says itself that evidence for specific prevention steps is limited.

One survey linked knee injuries with frequent strap use, an association only. The one lifting case of torn patellar tendons we found was during a heavy squat, after a recreational lifter doubled his load, not a deadlift.

Sources 13, 12, 33

How much pain is OK while you exercise?

0 to 2 safe, up to 5 acceptable, 3 for a tendon, back to usual by the next morningEmerging evidence

This guide uses the knee hub's rule, as our other knee guides do. Rate your knee pain from 0 to 10 during and after exercise. In the pain-monitoring model used in knee trials, 0 to 2 counts as safe, up to 5 as acceptable and above 5 as too much. Aim for 0 to 3 most of the time. By the next morning your knee should be back to its usual level. If it is not, drop back one step next time (fewer sets, a shallower range, a lower step), not to nothing. The scale comes from a pain-monitoring model used in a kneecap pain trial in 40 young women; continued loading under it did no harm in Achilles tendon pain, and exercise into some pain did no worse in long-lasting pain (7 trials).

For one sore point just below or above the kneecap (a tendon), keep it to 3 out of 10 or less, the patellar tendon trial's limit, and cut painful loading for the first weeks.

For deadlifts (our suggestion, built on the same rule): judge each set by its last reps, and use the start height (blocks, a rack or the floor), the stance, the bar and the load where your knee stays at 5 out of 10 or less (3 for a tendon) and is back to normal by the next morning. A pop, a knee that locks or gives way, new swelling, a knee that snapped back, a hot swelling over the kneecap or a swollen calf isn't a pain-rule question: see the warning signs.

Sources 34, 35, 36, 27

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep hinging at a height that passes the rule

About weeks 0 to 2, 2 or 3 sessions a week: keep the hips and hamstrings training with little knee bend, and start the knee and hip work the guidelines recommend. No deadlifts from the floor, deficit pulls or heavy trap bar pulls for now. With a diagnosed condition, that guide's plan comes first; after surgery, your team's plan does.

Hip-hinge practice demonstrated on the 3D figure

3D demoHip-hinge practiceBeginner · No equipment

2 or 3 sets of 10, knees soft · As in our deadlift back guide (editorial)

Harder: Kettlebell deadlift

Kettlebell deadlift demonstrated on the 3D figure

3D demoKettlebell deadliftBeginner · A kettlebell

3 sets of 8 to 10, light to start, the bell on a step or block if bending the knees to the floor hurts · As in our deadlift hip guide (editorial)

Easier: Hip-hinge practice · Harder: Dumbbell Romanian deadlift

Spanish squat (band squat hold) demonstrated on the 3D figure

3D demoSpanish squat (band squat hold)Intermediate · A band + An anchor point

For tendon pain: 4 to 5 holds of 30 to 45 s at a hard-but-OK effort, 1 to 2 minutes' rest, once a day · The move page's dose, modelled on the patellar tendon trial's holds

Easier: Straight-leg raise · Harder: Pistol squat

Leg extension demonstrated on the 3D figure

3D demoLeg extensionBeginner · Strength machine

For kneecap pain: 3 sets of 10 to 15, from 90 to about 45 degrees of bend only · As in our leg press guide (editorial)

Easier: Straight-leg raise · Harder: Barbell box squat

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

3 sets of 12 · As in our squatting guide (editorial); hip work alongside knee work, as the consensus recommends

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Recumbent exercise bike demonstrated on the 3D figure

3D demoRecumbent exercise bikeBeginner · Cardio machine

10 to 20 minutes at a moderate effort, building towards 30 · The move page's dose (an editorial starting point)

Harder: Stationary cycling

Move on when: Kettlebell deadlifts and the knee work pass the pain rule and your knee is back to normal the next morning, for a week (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build the hinge in a shorter range

About weeks 2 to 6, 2 or 3 sessions a week: heavier hinging with the bar starting higher, Romanian deadlifts with soft knees, single-leg and hip strength, and the back of the knee loaded gently.

3D demoRack pullAdvanced · A barbell

3 sets of 5, the bar just below the knee at about half your old working weight, lowering the pins over the weeks · As in our deadlift back guide (editorial)

Easier: Dumbbell Romanian deadlift

Dumbbell Romanian deadlift demonstrated on the 3D figure

3D demoDumbbell Romanian deadliftIntermediate · A dumbbell

3 sets of 8 to 10, knees soft and fixed, to knee height or mid-shin · As in our deadlift back guide (editorial)

Easier: Hip-hinge practice · Harder: Single-leg Romanian deadlift

Seated leg curl demonstrated on the 3D figure

3D demoSeated leg curlBeginner · Strength machine

2 to 3 sets of 8 to 12, stopping with 2 or 3 reps in reserve, in a range that stays within the pain rule · The move page's dose; for the hamstring tendons at the back of the knee

Easier: Seated band hamstring curl · Harder: Stability ball leg curl

3D demoStep-upBeginner · A step

3 sets of 8 to 10 each leg, a low step first · Editorial

Easier: Low step-up · Harder: Dumbbell step-up

Single-leg glute bridge demonstrated on the 3D figure

3D demoSingle-leg glute bridgeIntermediate · No equipment

2 or 3 sets of 10 to 15 each side · Editorial

Easier: Glute bridge · Harder: Barbell hip thrust

Lateral band walk demonstrated on the 3D figure

3D demoLateral band walkBeginner · A band

3 sets of 12 steps each way · As in our squatting guide (editorial)

Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet

Move on when: Rack pulls at about your old working weight pass the pain rule for a week, Romanian deadlifts to mid-shin are comfortable, and your knee is fine the next morning (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to the bar from the floor

From about week 6, often later for tendon pain: your usual deadlift, stance and bar, one change at a time by the written steps below. No study has tested a return to deadlifting after knee pain, so the order is editorial.

Barbell deadlift demonstrated on the 3D figure

3D demoBarbell deadliftAdvanced · A barbell

Sets of 3 to 5 with 2 or 3 reps in reserve, from the floor once rack pulls at your old working weight pass the rule, adding about 5% to 10% a week; heavy singles last · As in our deadlift back guide (editorial), using the American College of Sports Medicine's 2% to 10% steps for healthy adults

Easier: Dumbbell Romanian deadlift · Harder: Deficit deadlift

Sumo deadlift demonstrated on the 3D figure

3D demoSumo deadliftAdvanced · A barbell

If a wide stance suits your knees: 3 sets of 3 to 5 with 2 or 3 reps in reserve, starting light, the knees tracking over the toes · As in our deadlift hip guide (editorial)

Easier: Dumbbell Romanian deadlift · Harder: Reverse band sumo deadlift

Barbell Romanian deadlift demonstrated on the 3D figure

3D demoBarbell Romanian deadliftIntermediate · A barbell

3 sets of 6 to 8, to where your hamstrings stop you, knees soft · As in our deadlift hip guide (editorial)

Easier: Dumbbell Romanian deadlift · Harder: Romanian deadlift from a deficit

Trap bar (hex bar) deadlift demonstrated on the 3D figure

3D demoTrap bar (hex bar) deadliftIntermediate · Other / check instructions

Optional: 3 sets of 5 to 8 with 3 or more reps in reserve, high handles first; last with kneecap or tendon pain · Editorial; it loads the knee more than a straight bar

Easier: Dumbbell Romanian deadlift · Harder: Barbell suitcase deadlift

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

3 sets of 8 each leg · As in our lunge guide (editorial)

Easier: Bodyweight squat · Harder: Reverse lunge

Single-leg Romanian deadlift demonstrated on the 3D figure

3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell

3 sets of 6 to 8 each side, fingertips on a wall at first · As in our squatting guide (editorial)

Easier: Dumbbell Romanian deadlift

Move on when: Your usual deadlift sessions pass the pain rule for 2 weeks. If a session flares it, go back a stage for a few days, not to nothing (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your deadlift for now (written steps)

Our 3D figure can't show all of these. They come from our deadlift guide, lab studies of healthy lifters and a public health fact sheet; where a step is our reading or suggestion, it says so. No trial has tested a change to the deadlift for knee pain.

1. Bar path: the bar over the middle of your foot, close to your shins, dragged up your legs, as our deadlift guide teaches. If it scrapes, wear long socks or soft shin guards (our suggestion), and clean any cuts, as the NHS advises for skin over joints.
2. Start height: with kneecap or tendon pain, set your hips a little higher so your knees bend less, or pull from blocks or a rack with the bar just below the knee (our reading of the knee-load studies; not tested).
3. Stance: conventional, feet about hip-width; in sumo, only as wide as your knees can track over your toes, knees out over your feet rather than caving in. With inner knee pain, narrow the stance or pull conventional (our reading of the sumo knee loads).
4. Lockout: stand tall with straight knees, not snapped back. With knees that naturally bend back, stop just short of straight (our suggestion). A US Army fact sheet says fully locking the knees may increase damage to knee tissue or the hamstring; that is its statement, with no direct evidence behind it.
5. Romanian and stiff-legged deadlifts: knees soft and fixed, down to about knee height or mid-shin, where your hamstrings stop you. With back-of-knee pain, bend your knees a little more and shorten the range (our suggestion).
6. The bar: the trap bar is kinder to the back and hips but asks more of the knee; with kneecap or tendon pain, use the straight bar from blocks first (our reading).
7. Load: about half your old working weight, adding about 5% to 10% a week while your knee passes the pain rule (our suggestion, using the American College of Sports Medicine's 2% to 10% steps for healthy adults). The fact sheet notes knee braces haven't been shown to prevent weight-training injuries.

Sources 1, 2, 13, 5, 6, 7, 37, 19

Everyday life and sport (written steps)

The NHS's first steps for knee pain are to avoid long spells of standing, use an ice pack wrapped in a tea towel and simple painkillers, and to see a GP if it isn't improving within a few weeks. The rest are our suggestions unless a source is named.

1. Walking and stairs from the start, as comfort allows.
2. Kneeling jobs and floor work: a pad or cushion, and breaks, as the NHS advises for bursitis.
3. Lifting at work: hinge with the load close, hips a little higher if the kneecap complains.
4. Running, jumping and court sports: build back over a few weeks once your usual leg sessions pass the rule; with tendon pain, follow the tendon trial's order, which brings explosive and sport-specific exercises in last.
5. Cycling and swimming are fine throughout if they pass the rule.
6. Keep two strength sessions a week with hip and knee work for a few months after the pain has gone; the kneecap pain consensus favours hip and knee exercise together.

Sources 25, 19, 27, 29

Positions to swap, and why

Habit or position	Why it matters	Instead
Deadlifts from the floor with your hips low, like a squat	Your knees bend further at the start, and your shins push the bar forward (the knee link is our reading).	Hips a little higher, or a rack pull.Try: Rack pull
Bare shins dragging a rough bar	Scrapes and cuts can let infection into the skin or a bursa.	Long socks or soft shin guards, and clean any cuts.
A wide sumo stance with your knees caving in	The fact sheet lists knees collapsing inwards as a fault, and sumo adds side-to-side load at the knee.	A narrower stance with your knees over your toes, or a conventional pull.Try: Barbell deadlift
Snapping your knees back in stiff-legged deadlifts or at lockout	A US Army fact sheet says fully locking the knees may increase damage to knee tissue or the hamstring (its statement, not tested).	Stand tall with straight, not locked-back, knees; Romanian deadlifts with soft knees.Try: Dumbbell Romanian deadlift
Deep Romanian deadlifts with back-of-knee pain	The hamstring tendons at the back of the knee are on stretch at the bottom (our reading).	A shorter range with a little more knee bend.Try: Dumbbell Romanian deadlift
Trap bar deadlifts with kneecap or tendon pain	The trap bar raised the load at the knee in lab studies (choosing against it is our reading).	The straight bar from blocks.Try: Rack pull
Deficit deadlifts while it's sore	A lower start bends the knees and hips further (our reading).	Blocks or a rack pull.Try: Rack pull
Going straight back to your old weight	Sudden jumps in load preceded the one lifting tendon tear we found, in a squat.	About half your old weight, adding 5% to 10% a week.Try: Rack pull
A knee brace as the fix	Knee braces haven't been shown to prevent weight-training injuries, the fact sheet says.	The staged plan.
Long rests from all leg work	Exercise is the first treatment for kneecap, tendon and meniscus pain.	The first-stage moves.Try: Spanish squat (band squat hold)

Routines to follow

Learn to deadlift: hinge to bar workout

A 30-minute session from the hip hinge to your first deadlift: hinge practice, kettlebell deadlifts, slow Romanian deadlifts, a light bar and a carry.

30 minBeginner9 movesA kettlebell, A dumbbell

Knee strengthening workout: from first steps to full range

A 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.

25 minBeginner13 movesA bench or box, A wall

Hamstring workout: Romanian deadlifts, curls and Nordics

A 35-minute gym hamstring workout: Romanian deadlifts for the hip, seated leg curls for the knee, single-leg Romanian deadlifts, then Nordic curls when ready.

35 minIntermediate7 movesA dumbbell, Strength machine

Deadlift strength workout: heavy pulls, deficit deadlifts, rows and grip

A heavy deadlift session for lifters past the beginner stage: heavy sets of 3 to 5, deficit deadlifts, back extensions, rows and farmer's carries.

55 minIntermediate9 movesA barbell, Weight plates

Sumo deadlift workout: learn the wide stance and build the pull

A 40-minute sumo deadlift session: open your hips, learn the wide stance with a dumbbell, then sumo deadlifts in sets of 5, a wide-stance hinge and a carry.

40 minIntermediate11 movesA dumbbell, A kettlebell

Posterior chain workout: good mornings, hip thrusts, back extensions and pull-throughs

A 45-minute gym session for the back of your body: light barbell good mornings, hip thrusts, 45 degree back extensions, cable pull-throughs and a carry.

45 minIntermediate8 movesCardio machine, A barbell

More moves for this area

Questions people ask

Why do my knees hurt when I deadlift?

Usually the start: hips set too low so your knees bend more, or the bar scraping your shins and kneecaps. Where it hurts is the clue. Around the kneecap is usually kneecap pain, one point below or above it a tendon, the inner knee in sumo the inner knee tendons, and the back of the knee in Romanian deadlifts the hamstring tendons.

Are deadlifts bad for your knees?

No. They ask less of the knee than squats, and the knee is a less common injury site in powerlifting. With a sore knee, a higher start or a rack pull usually lets you keep pulling.

Is it normal for the bar to scrape my shins?

The bar should stay close to your legs, so light contact is normal; scrapes and bleeding aren't. Wear long socks or soft shin guards and clean any cuts, because a hot, red swelling over the kneecap needs a same-day check.

Why does the back of my knee hurt on Romanian deadlifts?

Usually the hamstring tendons at the back of the knee, or the hamstrings and calf on stretch. Bend your knees a little more, stop at knee height or mid-shin, and see our behind-the-knee guide. A soft lump there is often a Baker's cyst.

Why does the inside of my knee hurt in sumo deadlifts?

A wide stance adds side-to-side load at the knee, and the inner knee tendons there are a common sore spot. Narrow your stance so your knees track over your toes, or pull conventional for a while.

Should I lock my knees at the top of a deadlift?

Stand tall with straight knees, but don't snap them back. A US Army fact sheet warns that fully locking the knees may increase damage to knee tissue or the hamstring, though that hasn't been tested.

Is the trap bar better for knee pain?

Usually not at first. It lowers the load on the back and hips but raises it at the knee, so in our reading the straight bar from blocks is the better start while the kneecap or tendon is sore.

Can I deadlift with patellar tendonitis?

Usually, from a higher start with a light load, keeping tendon pain at 3 out of 10 or less, as the patellar tendon trial did. Heavy trap bar pulls and jumping come back last.

Can I deadlift with a meniscus tear or knee arthritis?

Often, yes, in a range that passes the pain rule: exercise matched surgery for a worn meniscus tear and eases arthritis pain. A knee that locks needs checking first.

Why do my knees hurt the day after deadlifts?

Achy thighs or hamstrings a day or two after a heavy session are usually soreness. Pain at one point, swelling or catching isn't, and the map on this page shows where to go.

Do I need a scan?

Usually not: kneecap and tendon pain are recognised by examination, and scans of painless knees often show tears. A knee that locks, a suspected tendon tear or a fall that meets the Ottawa knee rule needs one.

When should I see a doctor?

Go to A&E for a knee that changed shape or swelled fast after a pop. Get a same-day check for a pop at the front of the knee with a knee you can't straighten, a hot, red swelling over the kneecap or a swollen, painful calf, and get advice from NHS 111 for a knee that locks, gives way or is hot and swollen with a fever. See a GP if it isn't improving within a few weeks; in the US, call 911 where this page says 999.

Related exercise guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.

When to get help first

Get urgent medical help if

See a doctor or physiotherapist if

Where does it hurt?

Understand it

What a deadlift asks of the knee, and what no study has countedEmerging evidence

Who gets itEmerging evidence

The back of the kneeEmerging evidence

When a scan helps, and what it can't tell youStrong evidence

How it usually goesMixed evidence

What helps, and how strong the evidence is

Deadlifts aren't bad for your kneesEmerging evidence

Conventional, sumo, Romanian and the trap barEmerging evidence

Kneecap pain: exercise first, with the hips and knees togetherStrong evidence

Patellar tendon pain: progressive loading within 3 out of 10Strong evidence

A worn meniscus and knee arthritisStrong evidence

Locked knees, straps and braces: what the fact sheet and surveys sayMixed evidence

How much pain is OK while you exercise?

0 to 2 safe, up to 5 acceptable, 3 for a tendon, back to usual by the next morningEmerging evidence

The exercise plan: 3 stages

Keep hinging at a height that passes the rule

Build the hinge in a shorter range

Back to the bar from the floor

What to change for now

Your deadlift for now (written steps)

Everyday life and sport (written steps)

Positions to swap, and why

Routines to follow

Learn to deadlift: hinge to bar workout

Knee strengthening workout: from first steps to full range

Hamstring workout: Romanian deadlifts, curls and Nordics

Deadlift strength workout: heavy pulls, deficit deadlifts, rows and grip

Sumo deadlift workout: learn the wide stance and build the pull

Posterior chain workout: good mornings, hip thrusts, back extensions and pull-throughs

More moves for this area

Questions people ask

Related exercise guides

Other pain guides

Sources