Creatine is largely accepted as an ergogenic aid in activities of short duration (less than 30 seconds) and of high intensity (2,3).  In these studies activities such as 1RM bench press, 1RM leg press and anaerobic running capacity have seen significant increases.  The human body utilizes three different energy systems when supplying energy for muscular contractions.  They are the adenosine triphosphate-phosphocreatine (ATP-PC), glycolysis and the oxidative phosphorylation systems.  The use of a creatine supplement has been proven to increase the creatine stores in the muscle fibers which allows for faster ATP production via the ATP-PC system (2,3). Research indicates a safe dosage consists of a 20g/day loading phase for 5-7 days with these daily doses being broken down into 5g ingested four times per day followed by a maintenance phase of 3-5g/day (1).

Health Risks

One concern with any nutritional supplement is the possibility of long-term and short-term health risks.  Anecdotal evidence has linked creatine use to short-term health concerns such as Gastrointestinal (GI) Distress which can include vomiting and diarrhea and more serious long- term concerns such as muscle, liver and kidney damage.  My review of the literature finds nothing to date that scientifically supports damage to the muscle, liver or kidneys (1,4,5). One study followed professional basketball players for three seasons, measuring various muscle, liver and kidney blood markers and found no significant outliers (5).  Although the literature does not suggest GI distress to be of concern, one study did find that a dose of 10g/day consumed all at once caused slightly more GI distress in the form of diarrhea than those participants who took 10g/day but the 10g was broken into two doses of 5g taken 12 hours apart (4). But as mentioned in the introduction, 10g/day falls outside of the accepted healthy range of 5g/day (3,4).

Performance Enhancer or Diminisher?

As stated above, creatine supplementation aids the ATP-PC energy system and has been proven to benefit activities that are of high intensity and short duration, lasting 30 seconds or less (2,3).  Activities such as football, short running and cycling sprints and weightlifting are just a few.  Activities of longer durations that rely on the oxidative phosphorylation energy system have not been proven to benefit from a creatine supplement (3). There is conflicting evidence whether creatine  causes an increase in bodyweight (2,3).  This may be of concern if your activity is weight sensitive and one or two pounds of
bodyweight can have a detrimental effect on the outcome of your performance. There  is also conflicting evidence about whether men and women benefit equally.  One study showed that men’s anaerobic running  capacity increased but the women participants’ did not (2).

Conclusion

The current research findings suggest the use of a creatine supplement to be safe and effective for healthy individuals participating in activities that require short burst of muscular strength and power.

References

1.  Bemben, M.G., & Lamont, H. S. (2005). Creatine Supplementation and Exercise Performance: Recent Findings. Sports Medicine, 35(2), 107-125.

2.  Fukuda, D.H., Smith, A. E., Kendall, K. L., Dwyer, T. R., Kerksick, C. M., Beck, T. W.,Cramer, J.T., Stout, J. R. (2010). The Effects Of Creatine Loading And Gender On Anaerobic Running Capacity. Journal Of Strength & Conditioning  Research (Lippincott Williams & Wilkins), 24(7), 1826-1833.

3.  Herda, T.J., Beck, T. W., Ryan, E. D., Smith, A. E., Walter, A. A., Hartman, M. J., Stout, J.R., Cramer, J. T. (2009). Effects Of Creatine Monohydrate And Polyethylene Glycosylated Creatine Supplementation On Muscular Strength, Endurance,  And  Power Output. Journal Of Strength & Conditioning Research (Lippincott Williams & Wilkins), 23(3), 818-826.

4.  Ostojic, S. M., & Ahmetovic, Z. (2008). Gastrointestinal Distress After Creatine Supplementation in Athletes: Are Side Effects Dose Dependent? Research In Sports Medicine, 16(1), 15-22.

5.  Schröder, H., Terrados, N., & Tramullas, A. (2005). Risk Assessment Of The Potential Side Effects Of Long-Term Creatine Supplementation In Team Sport Athletes. European Journal Of Nutrition, 44(4), 255-261.

Disclaimer:  This posting does not include my recommendation to use creatine or my endorsement for any brand or manufacturer.

The Human Movement System (HMS) is a beautiful yet intricate system.  In layman’s terms when the HMS is functioning optimally the body is said to be  firing on all cylinders.  When there is dysfunction in the HMS, body parts start to wear out and break down.  But what exactly is the HMS?  The HMS is the skeletal, nervous, and muscular systems working interdependently to produce optimal neuromuscular control.  In order for optimal neuromuscular control to  be achieved the body must start in an ideal posture state.  When the body is properly aligned there are normal length-tension relationships, force couples and joint arthrokinematics.  The muscle has an optimal length that allows it to produce the most tension.  This is termed the length-tension relationship.  When the optimal length-tension is disrupted there is dysfunction which can result in reciprocal inhibition.  As noted the muscles function interdependently of each other.  The agonist may produce the prime movement but it is also the work of the antagonist, synergists and stabilizers that allow the entire movement to  happen.  It is the synergy of all the muscles and their independent actions that provide for an unhindered force couple.  If this force couple is disrupted  it will result in synergistic dominance where the synergists and stabilizers will take over for the prime movers, hence, doing a task they were never designed to do and increasing the risk of injury.  The joints also have an optimal range of motion.  When these normal ranges of motion are disrupted joint arthrokinetic inhibition can occur affecting the muscles surrounding the joint.  When the HMS is functioning optimally there is optimal sensorimotor integration,  neuromuscular efficiency and tissue recovery.  When the system is disrupted there is altered sensorimotor integration, neuromuscular efficiency and tissue fatigue and break down.

Often the first thing that presents itself is the symptom of a dysfunction in the HMS.  As health professionals I want us to start looking past the symptom to identify and address the cause.  This is very applicable from the client who has back pain to the soccer player with Iliotibial Band Syndrome (ITBS).  What problems may arise from poor posture?  If an athlete has a weak hamstring what are the parts of the HMS that may be altered?  We must ask ourselves where in the kinetic chain is the problem occurring?

The Trickle Down Effect

The most common lateral, overuse injury in runners is ITBS (Falvey et al., 2010; Grau, Maiwald, Krauss, Axmann & Horstmann, 2008).  The Iliotibial Band (ITB) is a thick fibrous tissue that runs from the Tensae Fasciae Latae (TFL) to the lateral femoral epicondyle. Patients and/or athletes will usually complain of a lateral knee pain.  At first glance one may think that the problem is isolated to the lateral, distal part of the femur.  But as was discovered earlier the HMS functions as an interdependent system.  The laymen train of thought would be that ITBS must be caused by a tightITB.  Therefore, stretch the ITB and this should solve the problem.  The professional says let’s look at the whole kinetic chain.  Devan, Pescatello, Faghri & Anderson (2004) studied 53 NCAA Division 1 female athletes and found that a tight ITB did not lead to ITBS but a decreased Hamstring to Quadriceps ratio (H:Q), as well as, genu recurvatum increased the athlete’s risk to overuse injuries at the knee.  Another study linked ITBS to decreased hip adduction, less internal and more external rotation of the tibia and less eversion at the subtalar joint (Grau et al., 2008).  Findings such as these mentioned above and understanding the dynamic relationship of the HMS can also help the athletic trainer and/or physical therapist when diagnosing and treating injuries.  A study by (Falvey et al., 2010) on 20 human cadaver ITBs suggested that the treatment should be directed at lengthening the TFL and gluteus maximus rather than the ITB.  Fredericson & Wolf (2005) mentioned another example of treating a part of the kinetic chain not necessarily near the presenting problem.  They suggested that a tight gastrocnemius and soleus leads to decreased dorsiflexion leading to increased ankle pronation and knee flexion, hence, increasing the risk of ITBS.

Conclusion

For optimal function of the human body an interrelated muscular, nervous, and skeletal system termed the Human Movement System must be viewed in its entirety.  As a health professional we should ask ourselves- What is the cause of the problem not just focus on the symptom or presenting problem.

References

Devan, M. R., Pescatello, L. S., Faghri, P. P., & Anderson, J. J. (2004). A prospective study of overuse knee injuries among female athletes with muscle imbalances and structural abnormalities. Journal Of Athletic Training, 39(3), 263-267.

Falvey, E. C., Clark, R. A., Franklyn-Miller, A. A., Bryant, A. L., Briggs, C. C., & McCrory, P. R. (2010). Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scandinavian Journal Of Medicine & Science In Sports, 20(4), 580-587.

Fredericson, M., & Wolf, C. (2005). Iliotibial band syndrome in runners: innovations in treatment. Sports Medicine, 35(5), 451-459.

Grau, S., Maiwald, C., Krauss, I., Axmann, D., & Horstmann, T. (2008). The influence of matching populations on kinematic and kinetic variables in runners with iliotibial band syndrome. Research Quarterly For Exercise & Sport, 79(4), 450-457.

Written by PJ Musilli CSCS

“The body is the storehouse of the emotional pain of early life as well as the consequences of trying to deal with that pain through coping mechanisms such as repression and compensatory activity…Emotions are energy.”

Yes, we must exercise and eat well to maintain our bodies.  And, the body has other needs as well.

Secondly, let me tell you about my experience training for my first sprint distance triathlon.  I get the bright idea I want to do a triathlon.  So, I get a book at the library with pre-made workouts.  The first swim workout calls for a 300 meter warm-up.  Easy enough.  Wrong!!!  I didn’t even make it 50 meters and I was gasping for air and had to stand up in the pool.  And that is NO exaggeration.  Swimming just for recreation or just to keep your head out of the water is totally different than swimming with your face in the water and turning your head every so often to get a breath of air.  So, what did I do?  I turned to the internet to learn how to “swim” and found the excellent site and resource www.totalimmersion.net.  It is through their book and website that I was able to go on and complete not only my first triathlon but several others after that.  Trust me if I could learn how to swim and not sink anyone can.  Here is a picture of me finishing one of my first Olympic distance triathlons.