How Creatine Will Boost Your Athletic Performance
WHAT IS CREATINE?
Creatine is a naturally occurring non-protein amino acid. In our diet, creatine can be found in meat and fish. Within our bodies, 95% of creatine is located in skeletal muscle.
The purpose of creatine is to help with energy production, especially during high intensity, anaerobic exercise, such as heavy lifting and short-duration interval training. Supplementation with creatine has been shown to increase muscle mass and strength, as well as enhance recovery. [1,2]
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Creatine is one of the most researched and evidence-backed legal supplements available to athletes. Numerous studies have demonstrated the safety of long-term use, with trials running for 5 years with intakes of up to 30g per day with well-tolerated outcomes in both healthy and patient populations across the lifespan. [1]
IS CREATINE SAFE?
The safety of creatine monohydrate has been extensively researched. [9-11] When taking the recommended dosage levels of creatine, there is no evidence that it has adverse effects on kidney function, muscular processes or thermoregulatory processes.
Furthermore, a 2017 study by Rawson et al. showed improvement in muscular functioning as demonstrated by decreased cramping and tightness and reduced total injuries reported in individuals taking creatine supplements. [11]
In addition, Lopez et al showed a reduction in body temperature with exercise in creatine users, demonstrating that the idea that creatine places an additional strain on the body’s thermoregulation process is unfounded. [12]
The International Society of Sports Nutrition (ISSN) position stance on the safety and efficacy of creatine supplementation states that “In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads.” [1]
THE BENEFITS OF CREATINE
REDUCTION IN RISK OF OVER-TRAINING INJURIES
Research has demonstrated significant effects regarding creatine supplementation and muscle recovery. In multiple studies, ingestion of creatine with glucose led to enhanced storage and retention of creatine and carbohydrates in skeletal muscle. [3,4]
When compared to carbohydrate loading alone, creatine loading coupled with carbohydrate loading prior to high intensity exercise produced better glycogen restoration. [5] These results are important because glycogen restoration promotes recovery and reduces risk of over-training injuries for high intensity athletes.
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Additional evidence supports that supplementation with creatine can reduce muscle damage. One study demonstrated greater muscle strength during recovery following exercise-induced muscle damage in participants who were given creatine. [6] Enhanced recovery after heavy training allows athletes to continue to train under intense loading with reduced risk of injury and overuse injury, allowing for greater training adaptations.
PREVENTING MUSCLE ATROPHY
Further research has been done regarding creatine supplementation effects on muscle atrophy during periods of limb immobilization due to injury and subsequent rehabilitation phase. A study by Hespel et al. looked at the effects of creatine use and muscle atrophy in subjects who had their legs immobilized in a cast for two weeks. The results of the two weeks of immobilization and 10 week rehabilitation period showed that subjects in the creatine group (20g/day down to 5g/day) had a faster recovery rate of quad strength and muscle mass than the control group (who did not receive creatine) during the rehabilitation phase. [7]
POST SURGERY BENEFIT
In a similar study, Op’t Eijnde et al. found that creatine use reduced the amount of muscle GLUT4 protein loss during immobilization. [8] GLUT4 protein plays an important role in glucose uptake into skeletal muscle, thus controlling energy production, muscle maintenance and glucose homeostasis. Based on the role of GLUT4 protein and creatine’s effects on GLUT4’s levels, researchers concluded that creatine supplementation can reduce the degree of muscle atrophy during periods of immobilization. Their results also supported what Hespel concluded in that creatine use can stimulate muscle hypertrophy after immobilization, during the rehabilitation phase. [7,8]
WHO SHOULD TAKE CREATINE?
Athletes: The research shows positive effects on athletes who perform brief, high-intensity activities of less than 30 seconds, such as sprinters and weightlifters. [9,14]
It is more challenging to measure the effects of creatine supplementation on team sport performance. A study from 2002 by Cox et al, for example, looked at elite soccer players. With creatine supplementation, players did not demonstrate improved kicking accuracy. However, the creatine-users sprinted faster than their non-creatine counterparts, thus demonstrating a performance benefit to creatine supplementation. [21]
Resistance Training vs. Aerobic Training: When compared to resistance training alone, studies show that individuals who combine creatine supplementation with resistance training demonstrated higher total lifting volume and ability to perform a greater number of repetitions at a given weight. This finding has been consistent across studies. [15-17]
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There is less research to support an additional performance benefit for activities extending beyond 30 seconds in duration. However, some studies have shown an ergogenic effect of creatine supplementation when sprints are included in endurance activity. [18-20]
The Elderly: Older populations can benefit from creatine supplementation as most studies support the findings of improved lean mass and muscle function in elderly populations, regardless of health status, sex or fitness level. [13]
Females: There is far less research specific to creatine supplementation in women, despite differences between males and females in storage, metabolism and utilization of creatine. In the studies mentioned below, females do demonstrate benefits from creatine supplementation, without additional risk of adverse outcomes! [22,23]
One study by Vandenberghe et al looked at the effects of creatine supplementation on muscle performance in resistance training in females over a 10 week period.
They found that compared with the control group who was not given creatine, the creatine supplement group had significantly greater increases in maximal strength, maximal intermittent exercise capacity and increased fat-free mass.
Therefore, the researchers concluded that creatine supplementation has a significant ergogenic effect on maximal muscle strength, fat-free mass, and work capacity for high-intensity intermittent exercise in females. To note, the experimental group underwent a 4 day high-dose creatine loading period of 20g/day, followed by a low-dose creatine intake of 5g/day for the remainder of the 10 week study period. [22]
In another study by Gotshalk et al, researchers looked at the effects of creatine ingestion on muscular performance in older women (aged 58-71 years). [23]
They found that just 7 days of creatine supplementation (dosage= 0.3 g/kg body mass) significantly improved scores on bench press, leg press and fat free mass. Additionally, the creatine group had a significant reduction in time needed to complete gait tests. Their placebo counterparts did not demonstrate significant changes in any of the measured variables.
Furthermore, no adverse side-effects were reported throughout the study. The researchers were able to conclude that a short duration of oral creatine ingestion resulted in improvements in strength, power and functional lower extremity motor output testing. [23]
Another study showed no differences between men and women in exercise performance improvements with creatine supplementation. [26]
DOES TIMING MATTER?
The debate of pre versus post workout supplementation:
One study by Antonio and Ciccone looked at 19 male bodybuilders over the course of four weeks. Subjects were assigned to either the pre or post workout groups, where the pre workout group took 5g of creatine immediately before exercise. The post group took 5g of creatine immediately following exercise. No significant interactions were found.
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However, after utilizing magnitude-based inference (MBI is a statistical analysis method to draw conclusions about the true value of an effect statistic), the researchers inferred that utilizing creatine immediately POST workout is potentially more advantageous, with regards to body composition and strength (specifically for this study: fat-free mass, total fat mass and one rep max bench press).
OPTIMAL DOSE
A common creatine supplementation protocol (and one that is used in many studies) includes an initial loading phase of 20g of creatine/day, taken in 4 doses of 5g at a time throughout the day. [25] A maintenance phase follows the loading phase, which includes a lower-dose daily intake of 3-5g of creatine.
Other protocols forego the loading phase and typically consist of a single dose of 3-6g creatine, however this approach requires more time to maximize your creatine muscle stores and therefore takes longer to see performance benefits.
Kelly Wild is a licensed physical therapist and member of California Strength’s Olympic weightlifting team. You can connect with Kelly on Instagram @kellywild8 or book an in-person appointment with Kelly at Ironhorse PT & Pilates in San Ramon
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Sources:
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2. Kreider, Richard B. "Effects of Creatine Supplementation on Performance and Training Adaptations." Mol Cell Biochem 244.1-2: 89-94. Web.
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