Does creatine decrease muscle damage?

Creatine and Muscle Damage

There are quite a few supplements which claim to reduce muscle damage; creatine is one of them. The implications of this claim is quicker recovery, reduced soreness, and increased performance gains. There has been plenty of research conducted on whether or not creatine supplementation reduces muscle damage. Let’s take a look.

What does the research say about creatine and muscle damage?

Long Distance Running

In one study, researchers looked at the effects of supplementation on muscle damage after a long distance, 30km race. Subjects supplemented with 4 doses of 5 grams of creatine monohydrate per day. Results showed the subjects who took creatine had significantly decreased levels of blood markers of muscle damage. The authors of this study concluded that creatine supplementation reduced damage¹.

Resistance Training

Creatine is a popular supplement used to enhance the effects of resistance or strength training. One study found that during 8 weeks of resistance training, creatine increased strength. The groups taking creatine also saw increased muscle damage. The authors of this study noted that creatine may have increased exercise intensity which would have led to more muscle damage. Increased muscle damage also leads to increased protein synthesis and greater muscle adaptation to the exercise².

In another study, researchers found that after 19 days of resistance training, supplementation resulted in decreased muscle damage³. The last study tested the effects of creatine on muscle damage after five days of supplementation. This study did not find any difference in muscle damage or soreness between the creatine and placebo groups⁴.

High Intensity Interval Training (HIIT)

HIIT is a demanding type of exercise associated with ample muscle damage and soreness. The authors of this study created a HIIT protocol to test whether creatine was effective in reducing muscle damage. The protocol consisted of 5-repetition max squats, followed by 8 repetitions of vertical and squat jumps. Subjects completed 6 sets. Researchers found creatine kinase levels, a measure of muscle damage, was significantly lower in the creatine group than the placebo group. Authors concluded that creatine reduced muscle damage⁵.

What does this research mean?

The research on creatine use to decrease muscle damage is somewhat mixed. The studies using running and HIIT saw a decrease in damage after creatine use. Two out of three studies looking at resistance training did not. It appears creatine decreases muscle damage in some circumstances. This isn’t all bad news for the supplement.

Creatine has been shown to improve performance in activities requiring short bouts of effort such as resistance and strength training. It’s much less effective in workouts requiring a lot of effort over a prolonged period of time: long distance running or HIIT. It’s not surprising that creatine reduces damage in activities where it does not increase performance.

One explanation is that creatine might be good at reducing muscle damage, but not good enough to offset the extra damage seen in activities where creatine improves performance. Creatine might improve performance and intensity in resistance training so much, that it cannot offset the extra muscle damage that the increased performance caused.

The Bottom Line Recommendations: Creatine Use for Decreasing Muscle Damage

Use the following guidelines:

• All of the studies cited in this article used creatine monohydrate. You should use this form of creatine as it’s the most widely available, cheapest, and most effective.
• You can either start with a loading protocol for your first week of use then decrease to a maintenance phase, or start with a maintenance protocol (similar results with both methods):
  • Loading protocol:
    • first week: 20 grams of creatine per day split into four 5g servings throughout the day
    • after first week: 5 grams of creatine per day in one serving
  • Maintenance protocol:
    • start: 5 grams of creatine per day in one serving
• If creatine use results in gastrointestinal discomfort, try smaller servings and avoid use immediately before exercise.
• Note: creatine monohydrate does cause significant weight gain in most individuals.

References

1. Santos, R., Bassit, R., Caperuto, E., & Rosa, L. (2004). The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30km race. Life Sciences, 75(16), 1917-1924. doi:10.1016/j.lfs.2003.11.036
2. Kaviani, M., Abassi, A., & Chilibeck, P. (2019). Creatine monohydrate supplementation during eight weeks of progressive resistance training increases strength in as little as two weeks without reducing markers of muscle damage. The Journal of Sports Medicine and Physical Fitness, 59(4). doi:10.23736/s0022-4707.18.08406-2
3. Veggi, K. F., Machado, M., Koch, A. J., Santana, S. C., Oliveira, S. S., & Stec, M. J. (2013). Oral Creatine Supplementation Augments the Repeated Bout Effect. International Journal of Sport Nutrition and Exercise Metabolism, 23(4), 378-387. doi:10.1123/ijsnem.23.4.378
4. Rawson, E., Gunn, B., & Clarkson, P. (2001). The effects of creatine supplementation on exercise-induced muscle damage. Journal of Strength and Conditioning Research, 15(2), 178-184.
5. Wang, C., Fang, C., Lee, Y., Yang, M., & Chan, K. (2018). Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients, 10(11), 1640. doi:10.3390/nu10111640