Creatine and Recovery
In the previous article, we learned the evidence paints a mixed, but positive picture on whether creatine decreases muscle damage. The next question is, if creatine has a moderate ability to decrease muscle damage, can it also speed up the post exercise recovery period?
Exercise induced muscle damage (EIMD) is the result of a new workout routine or high intensity activity. Though it may be painful and uncomfortable, it is a necessary process. EIMD leads to decreased muscle force, increased soreness, and impaired muscle function. This impaired muscle function means decreased speed, strength, and performance until the damage is fixed: the recovery period. Any methods that speed up recovery could improve training and possibly lead to a long term increase in performance1.
Is there any evidence to suggest creatine speeds up recovery?
Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals1
In this study, researchers recruited 14 subjects and split them between two groups: 1) creatine group, and, 2) carbohydrate group. Creatine monohydrate was dosed at 0.14 grams per pound of body weight (21 grams for a 150 pound individual) per day split between four doses. This was done for five days following by a dose of 0.05 grams per pound of body weight per day (7.5 grams for a 150 pound individual) for the remainder of the study.
Subjects performed 4 sets of 10 eccentric only repetitions on the leg press, leg extension, and leg flexion machines. Subjects then returned to the lab 1, 2, 3, 4, 7, 10, and 14 days later to evaluate post exercise recovery through performance and blood tests.
The results showed that following the initial exercise session, performance decreased significantly and remained low for 4 or more days in both groups. Strength was significantly higher during recovery in the creatine group than the carbohydrate group. The results also highlighted the blood markers of muscle damage, creatine kinase and lactate dehydrogenase, were significantly lower in the creatine group compared to the carbohydrate group. This indicated creatine reduced muscle damage post exercise.
The researchers concluded that creatine supplementation resulted in increased strength during the recovery period. This may have been caused due to faster muscle growth during recovery and/or less EIMD.
Creatine Supplementation Supports the Rehabilitation of Adolescent Fin Swimmers in Tendon Overuse Injury Cases2
The next study looked at creatine’s effect on tendinopathy of the flexor hallucis longus; an overuse injury affecting swimmers. Researchers recruited 18 subjects and assigned them to either a creatine or placebo group. Subjects took 20 grams of creatine monohydrate daily split into four even doses for the first five days. They decreased their intake to 5 grams daily for the remainder of the study.
All subjects showed signs of tendinopathy and underwent treatment. A medical specialist conducted an in depth examination to evaluate how well the treatment plan was working. Treatment included three phases and included an immobilization period, recovery phase, and a maintenance phase. All athletes, both in the creatine and the placebo groups, participated in the same treatment plan; the only difference was creatine use.
The researchers looked at many aspects of recovery to determine which group, if any, was recovering quicker. The first measure of recovery was segmental lean mass. This measured how much muscle was preserved in the injured area. The results showed segmental lean mass decreased 8.9% in the placebo group compared to 5.6% in the creatine group. The creatine group retained more muscle mass in the injured area.
Plantar flexion torque was also measured; the creatine group saw a 10.4% increase while the placebo group only saw a 7.1% increase. Subjective measures of pain were taken throughout the study and measured on a 10 point scale. Both groups started their recovery at the same level and saw significant decreases in pain as treatment progressed. The creatine group saw a slightly quicker decrease in pain than the placebo group.
Creatine kinase (CK), a measure of muscle damage, was also measured. Though the creatine group saw slightly lower levels of CK, the difference between the groups was not significant.
The authors of this study concluded that creatine supplementation was effective in accelerating recovery of the swimmers and that it may even prevent overuse injuries such as tendinopathy.
What does this research mean?
Both studies showed clear evidence that creatine improves the recovery process. Creatine decreased pain, increased muscle preservation or growth, and allowed athletes to regain strength quicker. This is inline with evidence in the previous article showing that creatine has the ability to decrease muscle damage.
Creatine Recommendations to Improve Recovery
Use the following guidelines to improve recovery with creatine:
- Both studies used creatine monohydrate to test recovery periods and so should you. It is the most widely available and cost effective form of creatine.
- Both studies used a loading phase protocol:
- Consume 20 grams per day (split into 4 even doses) for the first 5 days followed by 5 grams per day thereafter.
- Cooke, M. B., Rybalka, E., Williams, A. D., Cribb, P. J., & Hayes, A. (2009). Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. Journal of the International Society of Sports Nutrition, 6(1), 13. doi:10.1186/1550-2783-6-13
- Juhasz, I., & Kopkane, J. P. (2018). Creatine Supplementation Supports the Rehabilitation of Adolescent Fin Swimmers in Tendon Overuse Injury Cases. Journal of Sports Science and Medicine, 17(2), 279-288.