Does creatine reduce exercise-induced muscle damage?

Research examining the effect of supplementation with creatine on measures associated with exercise-induced muscle damage has provided somewhat paradoxical results.

Two 2021 meta-analyses found that creatine appears to blunt increases in the levels of creatine kinase and lactate dehydrogenase (indirect biomarkers of muscle damage), which suggests that creatine may promote recovery from muscle-damaging exercise.^[1][2] However, a more recent meta-analysis found that, although acute supplementation with creatine blunted increases in the levels of creatine kinase and lactate dehydrogenase following muscle-damaging exercise, chronic supplementation with creatine resulted in larger increases in the levels of these biomarkers of muscle damage.^[3] These findings suggest that creatine may promote the recovery from a single bout of muscle-damaging exercise, but that chronic supplementation may have the opposite effect.

One possible explanation for the findings above could be that, since creatine increases training performance and capacity over time, people who supplement with creatine may work their muscles harder than they otherwise would, which could eventually result in greater cumulative muscle damage.

With the above said, it should be kept in mind that supplementation with creatine doesn’t appear to have a consistent effect on other measures associated with exercise-induced muscle damage, including the recovery of exercise performance and muscle function, inflammatory biomarkers, range of motion, and delayed-onset muscle soreness in the hours following a muscle-damaging exercise bout.^[1][2][3]