Creatine during injury and rehab: does it help?
Creatine is one of the most researched supplements in sport. Most people know it for strength and power, but there's also some evidence that it may help when you're injured and rebuilding. Here's a balanced look.
This is general information, not individual dietary advice. Steven is an osteopath, not a dietitian. For a plan tailored to you, particularly if you have a medical condition, see your GP or an Accredited Practising Dietitian or sports dietitian.
What is creatine?
Creatine is a compound your body makes from amino acids and also gets from meat and fish. It's stored in muscle and used to regenerate energy during short, intense efforts such as lifting, sprinting and jumping. Supplementing with creatine monohydrate increases the amount stored in muscle.
Does creatine help with injury recovery?
Possibly. In a double-blind trial, healthy volunteers had one leg immobilised in a cast for two weeks, followed by ten weeks of knee-extension rehabilitation. Muscle size and power fell by a similar amount in both groups during immobilisation, but during rehabilitation they recovered faster in the group taking creatine than in the placebo group (Hespel et al., Journal of Physiology, 2001). It's a small study in healthy young people rather than patients with real injuries, so it's promising rather than conclusive.
Does creatine stop muscle loss when a limb is immobilised?
In that trial, creatine didn't prevent the loss of muscle during the two weeks in a cast. Its benefit appeared during the rebuilding phase, when the muscle was being trained again. That fits with how creatine works: it helps you do more high-quality training, and the training drives the gains.
What does the wider research say?
The International Society of Sports Nutrition's position stand states that creatine monohydrate is the most effective nutritional supplement available to athletes for increasing high-intensity exercise capacity and lean body mass during training, and that research suggests it may also help with post-exercise recovery, injury prevention and rehabilitation (Kreider et al., JISSN, 2017). The evidence for performance is strong; the evidence for rehabilitation is smaller.
How much creatine should I take?
The common approach is 3 to 5 grams of creatine monohydrate a day, taken consistently. Muscle stores fill over three to four weeks. A loading phase of around 20 grams a day, split into four doses, for five to seven days fills stores faster but isn't necessary. Timing during the day doesn't matter much.
Is creatine safe?
The position stand concludes that creatine monohydrate is safe for healthy people at recommended doses, including with longer-term use. The most common effect is a small increase in body weight, mostly from water held in muscle. Some people get stomach upset with large single doses, which is another reason to skip loading or split the dose.
Who should check with a doctor first?
People with kidney disease or reduced kidney function, those taking medications that affect the kidneys, anyone who is pregnant or breastfeeding, and teenagers should get medical advice before using creatine.
Does creatine cause cramps or dehydration?
This is a common belief, but the position stand reports that the research doesn't support it, with studies finding no increase in cramping or dehydration in athletes taking creatine.
Does creatine help tendons, ligaments or bones heal?
There's no good evidence that creatine speeds the healing of tendons, ligaments or bone directly. Its potential role is in helping you regain muscle size and strength around the injured area during rehab.
Which type of creatine is best?
Creatine monohydrate. It's the form used in almost all of the research, and it's the cheapest. More expensive forms haven't been shown to work better. If you compete in a drug-tested sport, choose a product that has been independently batch-tested.
Should I keep taking creatine if I'm already using it and get injured?
There's no reason to stop because of an injury, and it may help when you return to training. If you're having surgery, tell your surgeon and anaesthetist about all supplements you take.
Does creatine help older adults rebuild strength?
Research in older adults suggests creatine combined with resistance training can give a small extra benefit to muscle mass and strength compared with training alone. As always, the training does most of the work, and older adults with health conditions or on medication should check with their GP first.
What matters more than creatine?
A good rehabilitation program, enough protein and energy, and sleep. Creatine is a small extra on top of those, not a substitute.
How can an osteopath help?
We assess the injury and build a progressive rehab program to restore strength and function, which is where any supplement can do its work. For supplement and dietary advice specific to you, we'll refer you to your GP or a sports dietitian.
See our post on protein and injury recovery and our training hub. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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