I took creatine and I got injured. Anybody who has spent time in a gym has heard this or similar statements from people who use creatine monohydrate supplements. But, does creatine really increase the risk of muscle injuries? Do you even need this amino acid supplement? In this review, I give you the facts you need to know.
What is Creatine?
Creatine is a naturally occurring substance in our bodies. It's actually an amino acid. Contrary to what some believe, it's not a steroid. On average we make 1-2 grams of creatine every day. Its also found in different animal foods (chicken, steak, fish, turkey, etc.), although in small amounts. Most people get about 1-2 grams per day. Vegetables do not have this compound. As such vegetarians and vegans consume less than meat-eaters and omnivores do.
Even though creatine first started to get popular in the early 1990s, the supplements have been studied for at least 50 years. There are hundreds –if not thousands –of studies on this supplement. I've probably read almost a thousand studies myself. There are studies in both men and women. There are studies performed on people who lift weights and take the supplement and studies of those who do not lift weights. There are studies in athletes and nonathletes.
Does Creatine Cause Injuries
I've read a good amount of research over the years and there is one thing that I never see in any of these studies. I have never seen a study that found that this supplement increased injuries. I've never seen a study that found creatine caused muscle tears or tendon tears – or any other injury for that matter.
So, why do people say that this supplement causes injuries?
This is what I think is going on. When people use a creatine supplement, it causes the muscles to become more powerful. At least one study of creatine supplementation found that the loading phase ramped up power after only 5 days! That’s impressive.
But…
Creatine only makes muscles more powerful. It doesn't make tendons or ligaments stronger.
Weight lifters need to remember that muscles adapt to exercise quickly because they have very good access to blood and all of its nutrients. The connective tissues of the body – ligaments, and tendons – take longer to increase strength. That’s because they don’t have a direct blood supply.
This means that while creatine may allow the muscles to handle more weight, it doesn't do the same thing in the ligaments and tendons. As such, it takes them longer to adapt.
If you were wondering do I need to cycle creatine read my review for more insight on this.
So, Does It Cause Injuries?
So basically, people who say this supplement caused their injury are wrong. Creatine didn’t do it. They did it to themselves by accident because they advanced their exercise program too fast for their bodies to adapt. The majority of research studies do not show increased injuries – and that may be because these studies are conducted under strict laboratory conditions.
The people in these studies take a pre-determined about of creatine (usually 5 to 25 grams per day) and lift weights under the guidance of trained exercise professionals. The exercise program is monitored and altered in accordance with sound exercise principles to reduce the risk of injury.
Contrast this with what happens in the “real world”:
- Bob buys creatine supplement and does the loading phase (or more) for a week
- In less than a month, Bob discovers that he can lift more weight.
- Bob gets excited and starts increasing the load he lifts more than he should.
- Bob’s tendons and ligaments have not gotten stronger and so Bob gets hurt.
- Bob then tells his friends that creatine caused his injury.
After spending countless hours reading through the research, I feel that in healthy people, creatine is one of the safest muscle-building supplements on the market today. I am very confident that if used properly, in conjunction with a sound exercise program, it does not cause injuries.
That said, most people do NOT need this supplement. Unless you are working out at a very high intensity, lifting weights so heavy you can only lift them 1-2 times, you just don't need it.
What do you think?
Well, imagine my concern when I tested 11,860 IU/L for CREATINE KINASE. As opposed to the standard range of 15-190. By my reckoning, I should have been VERY dead. Turns out to have been a reaction to a prescription statin I was taking. I was, Rhabd.
Bill, yes rhabdo can be a side effect of cholesterol medications. Rhabdo is “rare but serious side effect” they often mention during TV commercials for cholesterol drugs.
I have a review of rhabdo and personal training which you may want to look at. take a look at the CK levels of people who left comments there. here is the link http://www.joe-cannon.com/rhabdomyolysis-personal-trainers-exercise-review-symptoms-negatives-eccentric-fitness-bootcamp/
BS….I’ve trained for many years so my connective tissue was already strong but creatine caused a lot of injures. It has to do with the potassium and calcium in the muscles or something like that.
Dude, if you can show me a study showing creatine elevates injury to muscles etc I will be glad to look at it.
An effect of aging is weakened connective tissue. So if you have trained for years and feel your strength is reducing so have turned to creatine for a strength boost, likelihood is that the reduction of strength is the body recognising the weakened connective tissue. (Good ol aging process) So I have no doubt the creatine boost in strength will put additional strain on the tissue causing minor tears. Some people will age quicker than others. Just the way it is.
Chris, you make a good point that aging is complex and some people do age faster in some ways than others. Aging may also effect how creatine works in the body as well.
Hi. One thing your article didn’t address and I thought it would, was that creatine causes the muscles do retain and extraordinary amount of water, making them swollen. Which could lead to a higher frequency of soft tissue injuries.
Chuck, What would be the mechanism of the soft tissue injuries? Would it be that the increased fluid in the muscles puts extra pressure on the connection tissues?
Creatine will cause fluid retention. that as Im sure you know, is one of the most well documented side effects of creatine. On occasion, people have told me they have gained as much as 12 pounds in a month after taking creatine supplements but I usually expect less than this.
That said, would extra fluid in the muscles lead to greater soft tissue injuries? I have never seen any studies that have shown increased soft tissue injuries associated with creatine supplements, so if it occurs, I dont think its wide spread. If there is indeed a link to soft tissue injuries and the increased water retention due to creatine supplements (and Im not sure if a relation ship even exists) Id imagine it might be limited to those who took a LOT of creatine, more than is recommended.
Have you ever seen any research on this? Let me know if yes, Id love to take a look at it.
Hi Joe
I am lifting body weights for the past 6 months
I just started creatine and into my 2nd day of the loading phase
i have been feeling chronic pain my wrist and ankle
Is it due to creatine or due to my sudden increase in weight
Shitij, my guess is it would be the sudden increase in weights you are lifting. the loading phase does help people lift heavier weights – in as little as 5 days. That may be enough time for the rest of the body to adapt to the increase in intensity. Id also say the loading phase isn’t needed with creatine. studies show that 3 grams per day will work just as well as 25 g/day. It just takes about a month to kick in.
I have to say I agree with the tendon/muscle tear issues, 3 times a right pectoral issue, all three times while on creatine. I kept thinking it was only coincidence but three times over the course of 10 years and never an issue without it can’t be on accident.
The problem is that I didn’t go over my normal sets/weight. As a matter of fact, it was during warm up sets that a sharp pain presented itself in my right pec during two injury issues. Never again will I take creatine. Maybe its just me but this sucks.
true, makes perfect sense
I’ve been injured because of creatine too. I was pushing heavier weights than usual with no problems but in fact my body was really tired and I was losing concentration and form when training, so I ended up injuring my wrist. I learned the lesson, though, and now I know when I should go heavier and try not to over-train. Even if the creatine is telling me that I can train for another half an hour, I just do my routine as planned, no extra reps/sets.
However, I got here thinking this was an article about how creatine can help with injuries and I would like to tell you about my experience and also ask if someone has been in the same situation. I had a torn ACL 16 years ago. After having surgery three times my knee was left in a pretty messy state and it has never been the same since.
What I found is that, when I take creatine, my knee does not hurt as much and it rarely swells but, when I’m not, my knee starts swelling again even after a bit of light cycling on the static bike. I don’t know what the cause is but I love working out and the main reason I take creatine this days is to avoid the pain in my knee. I don’t go crazy. I’ve found that 2 – 4gr every day is more than enough for me (I’m 175cm and 68kg).
Hope this helps.
Pad, thanks for writing and for that interesting note about how creatine helped your injury. Ive never seen any studies on it but I will definitely keep this in the back of my mind and keep my eyes and ears open for anybody else who said creatine helped them heal faster also.
Glad you are doing ok now!
Having used a variety of creatine supplements at different stages and during different styles of training over the last 10 years I have now decided flat out that I won’t use them anymore.
Each period of creatine use has ended in tendon pain which has taken months of missed workouts and exercise to get over. I have tried it repeatedly, despite the bad results, due to the greatly reduced recovery periods I have experienced while taking even small amounts of the supplement. I dismissed the problem in the past as a result of pushing myself too hard due to the extra strength i felt during training as a result of the creatine. This was supported by a lot of articles such as this one.
The main problem is always in the arms. It’s very difficult to avoid tendon issues in my biceps and triceps because I use my arms for most exercises. Even though I am going out of my way to avoid isolated arm exercises and am training within my limits. Once again the result has been crippling tendon problems.
I am positive now that there are undocumented effects of creatine on tendons, maybe only in certain people. I expect that something will be published in the future to better fit the relationship between creatine supplementation, exercise and tendon strain/injury. I have learned my lesson for the last time and concluded that after a short period of use additional creatine is a far greater hindrance than help to my body.
I would strongly advise anyone experiencing tendon issues during or following a period of creatine supplementation to avoid its use in future altogether. There seems no way to work around it – and if you have to work around a supplement, what is the point anyway?
Ben, its very interesting what you say. We are only as good as the research that is out there. Maybe some smart grad student will do a good study on this and see if there is anything to whether creatine ramps up injuries or not.
Ben, thanks for sharing this. I found this discussion after searching on creatine and injuries.
I’ve only been lifting for 1 year and was anxious to see if creatine would be of help (I took Con-Cret micro-doses) for four weeks and experienced amazing feelings of strength. I added some weight but mainly added sets.
After the fourth week I noticed fatigue in my right elbow and wrist after pull-ups and during triceps exercises. I stopped the creatine and began researching exercises to build forearms but eventually was in to see the doctor about “tennis elbow”.
Luckily I haven’t had to stop training but I have dropped back on sets and a little weight. And I’m seeing a physical therapist to make sure I recover properly and don’t hurt myself again.
Lesson learned…
jeff, glad you are seeing a physical therapist!! 🙂
Joe,
Is there any reason to believe creatine can help with muscle injury?
I received repeated injury to my rectus femoris muscle 24 months ago and still get pain doing sit ups for example.
Have tried physio, massage, etc.
Would creatine help this muscle get stronger and in rehab?
Jason, I don’t remember ever seeing anybody reporting that creatine helps people recover from muscle injury or aid in rehab. As long as your healthy (no heart disease, kidney/liver problems or high blood pressure) I don’t think it will hurt you esp if you keep it to the maintenance phase. If you try and it helps -or doesn’t – let me know. wish I could be of more help.
Joe, I have been taking amplified Creatine 189 for about 5 days and from the day after I took the first dose my throat has been killing me. Could this be a side affect or a allergic reaction?
Mike hard to say as Im not sure whats in Amplified Creatine but if thats all that has changed in your life, get off of it and see if it goes away.
Is there a recomended dosage? Anything per/body weight?
Hey Mike, the maintenance phase of creatine is usually said to be about 3 grams per day. if you wanted something based on body weight, then Ive seen 0.3 grams per kilogram. There are 2.2 pounds in a kilogram so divide your body weight by 2.2 to get your weight in kilograms. Then multiply that by 0.3. I think either way will be fine.
I have tried everything – effervescent creatine, liquid creatine, Cell Tech, Ultimate Orange… and a few others. The Dr Max Powers Anabolic Stack works the best by far. I have been using this product off and on for the last seven years.
Before I started using the Dr Max Anabolic Stack, I weighed 159 pounds and my max bench was 240. After four months of taking creatine and working out four times a week, I weighed 182 pounds, and my max bench went up to 300! This product is only useful if you are lifting weights, though. It is not very beneficial for aerobic or stamina programs.
Erin, I looked up Dr Max Anabolic Stack and its got about 3 grams of creatine combined with several other things including tribulus, arginine, AKG and glutamine. It looks like a creatine / nitric oxide supplement to me. Id agree that its probably best used by strength trainers and not people who do a lot of aerobic exercise.
Chris. Thanks for your comments but I think you missed an important piece of info. I said I believe people progress themselves too fast. I’m not saying people should only lift to the strength of connective tissue. I’m saying that a delicate dance occurs between someones desire to be stronger and how fast the body can adapt.
Connective tissue will adapt when a stress is placed on it (Overload Principle). However too much stress applied too fast can lead to injury. The best way to avoid injuries is to use creatine along with a properly designed and periodized strength training program. This is very different from what most people in the gym do.
As I also said, I have never seen a published peer reviewed study that found creatine caused muscle or connective tissue injuries. This lead me to believe that the incidence is quite low (if it exists at all) and claims made about this are due primarily to exercise program design errors on the part of the lifter.
4 years later… Still worth answering:
Why take creatine in the first place, if I can’t really use the boost it gives otherwise I’ll snap my ligaments?
I’ve heard a few times people getting injured after starting with creatine… Considering that the best “supplement” you can have is consistency, creatine scores low with me…
C’mon people; you’re missing the elephant in the room. The author here says that creatine doesn’t cause injury, we do… by lifting beyond the means of our ligaments and tendons. But if you should only lift weight commensurate with the health and strength of your tendons doesn’t it make sense not to stimulate muscle growth beyond this, but allow it to occur naturally, along with the integrity of one’s connective tissue? The line of reasoning the author uses to debunk the claim that creatine causes injury, supports the very concern he attempts to address.
Excellent article!
Curt, yes Ive seen those reports and I believe that it was rhabdomyolysis and not creatine that caused the injuries. I am going to address this in a future review
Mary it can vary according to a persons age and nutrition. Generally I advise people to give it at least 6-12 months. I’m being conservative but I prefer that to being sorry later.
Question: What is the general “lag time” for tendons and ligaments? How long should a creatine user wait before they begin increasing weights, to allow the ligaments/tendons to catch up with the stronger muscles?
Great post. As you mention in your article the latest scientific research doesn’t show that creatine supplementation increases one’s risk of injury. I recall reading a study on professional basketball players in Spain who took creatine over a period of 5 years. The results show no greater incidence of injuries among these athletes.
The recent news of the football players who were injured should have made more mention of the extensive workouts they were doing. I think it consisted of several workouts a day with little care given to hydration too.
Curt
Good article. My son used creatine in the off season to prep for football. The gains were very noticeable. You can only be as strong as your joints. I’m going to social bookmark this.