If you’re a physio, you’ve probably heard this one before:

“I hurt my back deadlifting... I don’t think I should ever do them again.”

It’s a common story — and an understandable reaction. Deadlifts have long been framed as risky or dangerous, especially for those with a history of back pain. But here’s the truth:

Deadlifts aren’t the problem. Poor load management and fear-based avoidance are.

When done right, the deadlift isn’t just safe — it can be incredibly effective for building strength, improving function, and restoring confidence after injury.

So how do we help someone go from fearful to fully capable?

Let’s break it down.

1. Meet Them Where They’re At: Find a Baseline

The first step isn’t loading the bar — it’s listening to the person.
●   What movements do they avoid?

●    What positions feel safe vs threatening?

●    What’s their current level of function and capacity?

From there, find a starting point that allows for success with low threat. This might be:
●    A hip hinge drill with dowel feedback

●    A kettlebell deadlift from an elevated surface

●    A trap bar variation to reduce range or spinal loading

2. Expose, Adapt, Progress

Once you’ve established a baseline, it’s time to move — slowly, intentionally, and progressively.
Here’s what that process might include:
●    Gradual exposure to heavier loads

●    Exploring different ranges — including some spinal flexion

●    Introducing tempo work or pauses to build control

●    Modifying volume, intensity, or stance to meet individual needs

3. From Rehab to Performance

The goal isn’t just getting out of pain. It’s helping people return to meaningful movement — lifting their kids, doing CrossFit, hiking, or yes, pulling a heavy barbell off the floor.
By:
●   Reintroducing load gradually

●   Embracing movement variety

●   Reframing fear into confidence

The Takeaway

Deadlifts aren’t something to fear. When reintroduced with care, intention, and individualization, they become one of the most powerful tools in a rehab program.
✅ Respect pain, but don’t avoid movement.
✅ Load is not the enemy — poorly managed load is.
✅ Spines are strong. Deadlifts can help prove it.

Source:
1. Lecture ‘Weightlifting and Back Pain’ by Sonia Fierro