Can Creatine Help with Recovery?

TLDR:

• A study investigated creatine monohydrate supplementation for recovery from exercise-induced muscle damage, involving participants taking 3g daily.

• Findings showed enhanced recovery of maximal voluntary contraction (MVC) and reduced muscle fatigue in the creatine group.

• Creatine may promote muscle recovery, potentially benefiting athletes and general fitness practitioners, with a possible sex-specific effect in females regarding extracellular water.

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Transcript:

 Hey y'all, Dr. Wells here from Nutritional Physical Therapy. I've got my medicine ball here, ready to talk a little bit about some resistance training work and dietary supplementation with creatine. So in our three-part course series we talk a lot about creatine and we actually smile on it quite a bit because there's some good evidence for creatine increasing power in athletes and increasing one rep max. So what I wanted to talk about a little bit today is a new study that just come out, a double blind placebo-controlled randomized control trial. So I think it's a strong study. I also think it talks a lot about a really hot topic, which is recovery. So with this, the title of the article is the effects of creatine supplementation on recovery from eccentric-induced muscle damage. They also look at some sex and age differences as well. This is published by Yamaguchi et al. in the journal Nutrients. So it's 40 non-trained individuals, so that's important because a lot of the studies we see are in our athletes, right? And so it's a strong thing for some of our general physical therapy population, probably not so great for most of our sports physios that are working with well-trained athletes. We'll talk a little bit about that later. Average age about 27, 21 females, 19 males. And the methods is they were taking three grams of creatine monohydrate every day, 28 days leading up to this exercise-induced muscle damage. And a lot of it is eccentric-based, like eccentric bicep curls, right? And so not only did they take it leading up to the bicep curls, they also took it three days afterwards to see was there an effect on muscle performance, muscle damage, and recovery with that creatine supplementation. And no surprise, we saw an improvement and maximal voluntary contraction in the biceps immediately after and 48 days, or excuse me, 48 hours after. We also saw a significant reduction in muscle soreness at three intervals, so both immediately, 48 hours and 96 hours afterwards. And a reduction of fatigue and improvement in modulus shear. The modulus shear is effectively looking at muscle damage under ultrasound and looking at how much of those tissues are actually disrupted. Regardless, it seems to show that creatine supplementation significantly improves muscle recovery after eccentric muscle damage in non-trained athletes. So that's important because I feel like the study had it been done in athletes might not be as robust. Moreover, these are statistical differences. So when I actually look at the MVC, the maximal voluntary contraction, and those differences that they said were significant immediately in 48 hours afterwards, we're talking a small difference. So does that small difference really translate into a change in performance? Does it really mean that that athlete, or in this case, non-athlete, can really do that much more afterwards? Now, I kind of countered that by saying their muscle soreness was significantly reduced. And when I looked at it in some metrics, it was almost halved. So going from a 4 out of 10 soreness down to a 2 out of 10 soreness, I could say maybe we're talking clinical significance, not just statistical significance. So my opinion, great study, really well designed. I think what we need to see is also this to be replicated in the athletic population to see if those data points are as significant. The other thing would be to throw in some sort of functional assessment. So it's great that they have an increase in voluntary contraction of the bicep, but can they do as many pull-ups the next day? And so throwing in something like a metric of pull-up or push-up, obviously this is biceps loading, so you probably want to do something more biceps function oriented. Anyhow, great study, creatine 3 grams per day 28 days prior, and that's actually below what I recommend some of my patients to take. Sometimes it's up to 5 grams a day. It seems to be kind of that sweet spot. So I wonder if they had done a little bit more, if they had seen more robust outcomes. The other limitation I would say too is they didn't really talk about their diet as much. Obviously, vegans and vegetarians will have lower sources of creatine in their diet, so they actually have a stronger, more robust response to creatine supplementation