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The Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-Analysis

Kenji Doma, Akhilesh Kumar Ramachandran, Daniel Boullosa, Jonathan Connor

Sports Med 2022 52(7):1623-1645

Bibliography

PubMed: PMID 35218552
PubMed Central: PMC9213373
DOI: 10.1007/s40279-022-01640-z
Funding: Open-access funding was enabled and organized by CAUL and its member institutions; authors stated that no sources of funding were used to assist in preparation of the article.
Competing interests: Authors declared no conflicts of interest directly relevant to the article.

Study snapshot

Design	Systematic review and meta-analysis
Model	Human
Sample	23 studies; 240 creatine participants and 229 placebo participants
Intervention	Creatine monohydrate versus placebo around acute or chronic training-related muscle-damaging exercise
Duration	Varied; outcomes commonly analyzed at 24–36 and 48–90 hours after damaging exercise
Endpoints	Creatine kinase/LDH/myoglobin; Inflammation; Oxidative stress; DOMS; Muscle performance

What the study showed, in plain terms

Meta-analysis separating acute single-bout muscle-damage studies from chronic training contexts and showing that recovery-marker effects were inconsistent rather than uniformly beneficial.

Key findings

Indirect muscle-damage markers were lower at 48–90 hours after an acute damaging bout but higher at 24 hours in chronic-training analyses. Inflammation, oxidative-stress and DOMS differences were generally not statistically significant between groups. The pattern does not support a simple claim that creatine universally accelerates recovery.

What this study can and cannot tell us

Included studies were heterogeneous in exercise protocols, timing and biomarkers, and some pooled signals differed between acute and chronic training contexts. Biomarker changes were not consistently accompanied by improved muscle performance or soreness.

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Oct 2, 2026 Creatine for Strength and Performance: Power, Sprints and Endurance EvidenceCreatine performance evidence separated by outcome: strength, repeated high-intensity work, power, sprinting and why endurance results are much weaker.Read analysis

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Last verified 02 October 2026

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