If you've been hitting the gym, recovering from an injury, or wondering how to maintain muscle strength as you age, you've probably heard about creatine. But there's a lot of confusion out there. Some people swear by it, while others worry about risks like kidney damage. As physical therapists, our goal is to help you understand what the science actually says so you can make informed decisions about your health.

What Is Creatine, and How Does It Work?

Creatine is a natural substance your body produces in the liver and kidneys, and it's also found in foods like meat and fish. Your muscles use creatine to create energy during short, intense activities such as sprinting, weightlifting, or climbing stairs.

Supplementing with creatine increases the amount stored in your muscles, giving them more fuel during demanding exercise. Think of it like topping off your gas tank before a long drive–your muscles simply have more energy available to work hard and recover well.

The Real Benefits: What the Research Says

Stronger Muscles and Faster Recovery

Creatine has strong evidence supporting its ability to increase strength and speed recovery. Research shows it reduces muscle damage and helps people regain strength about 10–20% faster after hard workouts. This can be especially helpful during injury recovery or physical therapy.

Preserving Muscle as You Age

Age–related muscle loss, known as sarcopenia, can make daily life harder and increase fall risk. Studies show that older adults who combine creatine with resistance training gain more strength and function than with exercise alone–helping maintain independence and quality of life.

Benefits Beyond the Gym

Emerging research suggests creatine may also support brain health, cardiovascular function, and conditions like diabetes or fibromyalgia. While these areas are still being studied, the evidence continues to grow.

Setting the Record Straight About Common Concerns

The Kidney Damage Myth

Creatine does not damage healthy kidneys. Although creatinine levels may rise on blood tests, this reflects normal metabolism–not kidney injury. Long–term studies (up to 10 years) show no kidney harm in healthy individuals taking recommended doses.

Important note: If you have known kidney disease, consult your physician before using creatine.

Dehydration and Muscle Cramps

Creatine actually improves hydration inside muscle cells and has been shown to reduce cramps and heat–related illness. Staying normally hydrated is sufficient.

Gastrointestinal Issues

Stomach upset is uncommon and usually linked to large single doses. Splitting intake into doses of 5 grams or less prevents most issues.

How Much Should You Take?

Loading Protocol (Faster Results)

• 20 grams per day (4 × 5 g) for 5–7 days


• Then 3–5 grams per day

No–Loading Protocol (Simpler)

• 3–5 grams per day from the start


• Full benefits in ~3–4 weeks

Both approaches are equally effective long term.

Is It Safe Long–Term?

Yes. Creatine is one of the most well–researched supplements available and has an excellent safety profile when used at recommended doses.

Who Should Consider Creatine?

• Athletes or those performing high–intensity exercise


• People recovering from injury or surgery


• Adults concerned about age–related muscle loss


• Vegetarians or vegans

The Bottom Line

Creatine is a safe, evidence–based supplement that supports strength, recovery, and long–term muscle health–especially when combined with resistance training or physical therapy. Common fears about kidney damage, dehydration, or cramps are not supported by science.

Ready to Optimize Your Recovery?

If you're dealing with pain, recovering from injury, or want to build strength safely as you age, contact our practice today. Our physical therapists will create a personalized plan to help you recover, move better, and stay strong.

References and Further Reading

1. Creatine Supplementation: New Insights Into Health and Performance


2. Creatine Supplementation and Muscle Health: A Narrative Review


3. Creatine Dosage: How Much Should You Take Daily?


4. Common Questions and Misconceptions About Creatine Supplementation


5. Safety and Efficacy of Long-Term Creatine Use


6. Recommended Dosage and Possible Side Effects of Creatine


7. Creatine Supplementation in Health and Disease


8. Creatine and Aging: Effects on Muscle and Function


9. Creatine Supplementation for Adults Over 55


10. Creatine Supplementation and Exercise Performance


11. Creatine’s Role in Metabolism and Health