Exercise

May 9, 2011

Is Creatine Responsible for Oblique Injuries?

Injuries to the oblique muscles are becoming increasingly more common in baseball. In just the first few weeks of the season, more than a dozen players have experienced oblique strains!

In case you don’t know, the obliques are the “waist” muscles that reside on the sides of your midsection. Given that a primary function of the obliques is to twist the torso to the right or left, an injury will obviously put a crimp in your ability to hit or throw a baseball.

A recent article in the New York Daily News suggested that the dietary supplement creatine may be linked to the current oblique injury epidemic. According to Lewis Maharam, a sports physician and former president of the New York chapter of the American College of Sports Medicine, creatine “adds water molecules to muscle fibers, which causes the fibers to separate. This makes for easier muscle tears and slows the repair process, leaving them on injured reserve longer.”

These are some bold claims. However, with all due respect to Dr. Maharam, I could not locate one peer-reviewed study that even suggests such a cause-effect relationship. Sure, creatine increases intracellular hydration, but this shouldn’t pose any negative effect on muscle tissue. In fact, studies show that increasing water content in a cell has a positive impact on cellular integrity. Hydration-induced cell swelling causes both an increase in protein synthesis and a decrease in protein breakdown, which ultimately strengthens the cell’s ultrastructure (1). If Dr. Maharam or anyone else has evidence to the contrary, I would certainly like to see it.

Even more outlandish are the comments in the article by Migdoel Miranda, a personal trainer who apparently works with professional baseball players. Miranda states that “players should limit their use of creatine because it taxes bodies that are already stressed by long baseball seasons.” He then goes on to say that he’s “…not a fan of creatine unless we’re in the offseason. I think creatine should be banned by the team during the season.” Huh? Creatine is simply a high energy compound comprised of amino acids that is stored in muscles and assists in high-intensity exercise bouts. How can such a compound possibly “overtax” an athlete’s body? Again, the statement is completely unsupported by research. Since creatine helps athletes train harder, a case can be made that it may actually reduce the prospect of injury.

There are a couple of take-home messages here. First, just because someone has “credentials” doesn’t necessarily mean that they know what they’re talking about on a given subject. I’ve heard some pretty smart people say some pretty wild things that have no basis in reality–this serves as yet another prime example. Second, newspapers do nothing to check facts. At the very least, you’d have figured that the writer of the article would seek out other sources for confirmation of these claims. Not! The only thing that matters is selling papers. If this can be accomplished by splashing a headline that blames a supplement for sporting injuries, so be it.

Bottom line: There is no evidence I could locate that links creatine to an increased incidence of any type of musculoskeletal injury. The only published side-effects associated with creatine supplementation I’m aware of are some anecdotal reports of cramping, and these claims have recently been refuted (2). If anything, research indicates that creatine may in fact have a protective effect on muscle. It’s difficult to say what’s causing so many oblique injuries in professional baseball, but evidence suggests that creatine is not the culprit.

Stay Fit!

Brad

1) Schliess, F., Häussinger, D. (2002) The cellular hydration state: a critical determinant for cell death and survival. Biol. Chem. 383: 577J583.

2) Dalbo VJ, Roberts MD, Stout JR, Kerksick CM. Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration Br J Sports Med 2008;42:567-73