Over the years, there has been an increasing body of evidence in the use of creatine for a host of medical problems; the most common ones being genetic and inflammatory muscle disease. Whilst working in trauma and orthopaedics, I remember once seeing an athlete with worsening knee pain - they had very early osteoarthritis (OA). One of the things the patient asked me was “would creatine make the symptoms of arthritis worse?” My immediate answer was no, it shouldn’t. If anything, it should improve symptoms as part of a structured training and nutritional program, as creatine has been found to improve strength gains and increase muscle mass.
OA is the degradation of articular cartilage and subchondral bone in joints - it’s a degenerative condition. Sufferers develop pain, swelling, stiffness and even locking due to bits of cartilage floating around in the knee. It can lead to muscle wasting due to reduced levels of activity, and ligament problems. It makes sense therefore that in the early to middle stages of the disease, one of the best treatments is physical therapy and exercise, which improves function and decreases pain.
In the example of knee OA, quadriceps weakness is a common functional impairment. It has already been shown that if you improve the strength of the quadriceps, you can halt the progression of symptoms. Anything that can enhance strength gains theoretically will assist in the management of OA. Let’s introduce creatine to the equation. Creatine is important in the rapid provision of energy for muscle contraction. Increased creatine levels has been shown to enhance energy, strength, function, as well as various growth factors.
Neves et al 2011 investigated the efficacy of creatine supplementation combined with strengthening exercises in knee OA in postmenopausal women. This was a randomized, double blind, parallel-group and placebo controlled study - that means it was a good one!
The results showed that physical function was significantly better in the creatine group, as were symptoms of stiffness, and quality of life. There was an increase in lower limb lean mass in the creatine group as well. There was also no adverse effects in creatinine clearance i.e. kidney function.
Creatine is a safe supplement, and as far as I’m concerned it is underutilized in such populations. Creatine undoubtedly has therapeutic applications, and the medical world needs to be a lot more receptive to it.
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