To meet the increasing demand for higher flexibility in hydropower, an operating range extension in an existing hydroelectric powerplant is considered. To this end, the dynamic flow and structural behavior of the low-head pump-turbine is investigated in turbine mode in partial load and deep partial load conditions, to evaluate the feasibility of this flexibilization due to the increased high cycle fatigue damage. In a first step, different numerical simulation approaches that combine fluid dynamics and structural dynamics are applied and compared to in-situ dynamic strain and pressure measurements on the impeller. As a result, the modelling requirements for a numerical workflow that leads to unmatched accuracy in predicting the broad-band dynamic stresses of deep partial load are identified. In a second step, the operating-point-dependent fatigue crack initiation spots are identified based on dynamic stresses. Herein, the emergence of an additional dominant critical spot near the blade leading edge is observed, which is unexpected for low-head pump turbines. Thanks to the detailed numerical flow and structural analyses, the root cause for the dynamic stress concentration is studied and the emergence of the new critical spot is understood. It turns out in deep partial load, that the main source of pressure oscillations on the impeller blade surfaces is the vortex-dominated flow detachment zone around the blade leading edge, which, in combination with the geometry of the investigated impeller, translates into the main stress oscillations. The results of this work were later used to extend the operating range of the hydroelectric powerplant from initially 25% to 100% power output to now 0% to 100%.