Creatine is the most widely used supplementation to increase performance in strength; however, the most recent meta-analysis focused specifically on supplementation responses in muscles of the lower limbs without regard to upper limbs.
We aimed to systematically review the effect of creatine supplementation on upper limb strength performance.
We conducted a systematic review and meta-analyses of all randomized controlled trials comparing creatine supplementation with a placebo, with strength performance measured in exercises shorter than 3 min in duration. The search strategy used the keywords ‘creatine’, ‘supplementation’, and ‘performance’. Independent variables were age, sex and level of physical activity at baseline, while dependent variables were creatine loading, total dose, duration, time interval between baseline (T0) and the end of the supplementation (T1), and any training during supplementation. We conducted three meta-analyses: at T0 and T1, and on changes between T0 and T1. Each meta-analysis was stratified within upper limb muscle groups.
We included 53 studies (563 individuals in the creatine supplementation group and 575 controls). Results did not differ at T0, while, at T1, the effect size (ES) for bench press and chest press were 0.265 (95 % CI 0.132–0.398; p < 0.001) and 0.677 (95 % CI 0.149–1.206; p = 0.012), respectively. Overall, pectoral ES was 0.289 (95 % CI 0.160–0.419; p = 0.000), and global upper limb ES was 0.317 (95 % CI 0.185–0.449; p < 0.001). Meta-analysis of changes between T0 and T1 gave similar results. The meta-regression showed no link with characteristics of population or supplementation, demonstrating the efficacy of creatine independently of all listed conditions.
Creatine supplementation is effective in upper limb strength performance for exercise with a duration of less than 3 min, independent of population characteristics, training protocols, and supplementary doses or duration.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Wyss M, Kaddurah-Daouk R. Creatine and creatinine metabolism. Physiol Rev. 2000;80:1107–213.
Tscholl P, Alonso JM, Dolle G, et al. The use of drugs and nutritional supplements in top-level track and field athletes. Am J Sports Med. 2010;38:133–40.
Lanhers C, Pereira B, Naughton G, et al. Creatine supplementation and lower limb strength performance: asystematic review and meta-analyses. Sports Med. 2015;45:1285–94.
Gastin PB. Energy system interaction and relative contribution during maximal exercise. Sports Med. 2001;31:725–41.
Pollo A, Carlino E, Benedetti F. Placebo mechanisms across different conditions: from the clinical setting to physical performance. Philos Trans R Soc Lond B Biol Sci. 2011;366:1790–8.
Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.
Cohen J. Statistical power analysis for the behavioral sciences. Mahwah: Lawrence Erlbaum; 1988.
Aguiar AF, Januario RSB, Junior RP, et al. Long-term creatine supplementation improves muscular performance during resistance training in older women. Eur J Appl Physiol. 2013;113:987–96.
Bemben MG, Witten MS, Carter JM, et al. The effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older men. J Nutr Health Aging. 2010;14:155–9.
Candow DG, Little JP, Chilibeck PD, et al. Low-dose creatine combined with protein during resistance training in older men. Med Sci Sports Exerc. 2008;40:1645–52.
Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276:637–9.
Azizi M. The effect of a short-term creatine supplementation on some of the anaerobic performance and sprint swimming records of female competitive swimmers. Procedia Soc Behav Sci. 2011;15:1626–9.
Brenner M, Rankin JW, Sebolt D. The effect of creatine supplementation during resistance training in women. J Strength Cond Res. 2000;14:207–13.
Ferguson TB, Syrotuik DG. Effects of creatine monohydrate supplementation on body composition and strength indices in experienced resistance trained women. J Strength Cond Res. 2006;20:939–46.
Gualano B, Macedo AR, Alves CR, et al. Creatine supplementation and resistance training in vulnerable older women: a randomized double-blind placebo-controlled clinical trial. Exp Gerontol. 2014;53:7–15.
Hamilton KL, Meyers MC, Skelly WA, et al. Oral creatine supplementation and upper extremity anaerobic response in females. Int J Sport Nutr Exerc Metab. 2000;10:277–89.
Larson-Meyer DE, Hunter GR, Trowbridge CA, et al. The effect of creatine supplementation on muscle strength and body composition during off-season training in female soccer players. J Strength Cond Res. 2000;14:434–42.
Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol. 1985;83:2055–63.
Burke DG, Silver S, Holt LE, et al. The effect of continuous low dose creatine supplementation on force, power, and total work. Int J Sport Nutr Exerc Metab. 2000;10:235–44.
Burke DG, Chilibeck PD, Parise G, et al. Effect of creatine and weight training on muscle creatine and performance in vegetarians. Med Sci Sports Exerc. 2003;35:1946–55.
Stout JR, Graves BS, Cramer JT, et al. Effects of creatine supplementation on the onset of neuromuscular fatigue threshold and muscle strength in elderly men and women (64–6 years). J Nutr Health Aging. 2007;11:459–64.
Camic CL, Housh TJ, Zuniga JM, et al. The effects of polyethylene glycosylated creatine supplementation on anaerobic performance measures and body composition. J Strength Cond Res. 2014;28:825–33.
Peeters BM, Lantz CD, Mayhew JL. Effect of oral creatine monohydrate and creatine phosphate supplementation on maximal strength indices, dody composition, and blood pressure. J Strength Cond Res. 1999;13:3–9.
Pluim BM, Ferrauti A, Broekhof F, et al. The effects of creatine supplementation on selected factors of tennis specific training. Br J Sports Med. 2006;40:507–12.
Volek JS, Ratamess NA, Rubin MR, et al. The effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreaching. Eur J Appl Physiol. 2004;91:628–37.
Noonan D, Berg K, Latin RW, et al. Effects of varying dosages of oral creatine relative to fat free body mass on strength and body composition. J Strength Cond Res. 1998;12:104–8.
Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, et al. Effects of creatine supplementation on muscle power, endurance, and sprint performance. Med Sci Sports Exerc. 2002;34:332–43.
Law YL, Ong WS, GillianYap TL, et al. Effects of two and five days of creatine loading on muscular strength and anaerobic power in trained athletes. J Strength Cond Res. 2009;23:906–14.
Syrotuik DG, Bell GJ, Burnham R, et al. Absolute and relative strength performance following creatine monohydrate supplementation combined with periodized resistance training. J Strength Cond Res. 2000;14:182–90.
Warber JP, Tharion WJ, Patton JF, et al. The effect of creatine monohydrate supplementation on obstacle course and multiple bench press performance. J Strength Cond Res. 2002;16:500–8.
Bermon S, Venembre P, Sachet C, et al. Effects of creatine monohydrate ingestion in sedentary and weight-trained older adults. Acta Physiol Scand. 1998;164:147–55.
del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids. 2012;42:2299–305.
Earnest CP, Snell PG, Rodriguez R, et al. The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand. 1995;153:207–9.
Gotshalk LA, Volek JS, Staron RS, et al. Creatine supplementation improves muscular performance in older men. Med Sci Sports Exerc. 2002;34:537–43.
Stout J, Eckerson J, Noonan D, et al. Effects of 8 weeks of creatine supplementation on exercise performance and fat-free weight in football players during training. Nutr Res. 1999;19:217–25.
Rawson ES, Wehnert ML, Clarkson PM. Effects of 30 days of creatine ingestion in older men. Eur J Appl Physiol Occup Physiol. 1999;80:139–44.
Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc. 2014;46:1194–203.
Candow DG, Chilibeck PD, Forbes SC. Creatine supplementation and aging musculoskeletal health. Endocrine. 2014;45:354–61.
Villanueva MG, He J, Schroeder ET. Periodized resistance training with and without supplementation improve body composition and performance in older men. Eur J Appl Physiol. 2014;114:891–905.
da Silveira CL, de Souza TS, Batista GR, et al. Is long term creatine and glutamine supplementation effective in enhancing physical performance of military police officers? J Hum Kinet. 2014;43:131–8.
de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol. 2014;114:1749–55.
Brose A, Parise G, Tarnopolsky MA. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. J Gerontol A Biol Sci Med Sci. 2003;58:11–9.
Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res. 2003;17:822–31.
Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc. 2000;32:654–8.
Chilibeck PD, Magnus C, Anderson M. Effect of in-season creatine supplementation on body composition and performance in rugby union football players. Appl Physiol Nutr Metab. 2007;32:1052–7.
Burke LM, Pyne DB, Telford RD. Effect of oral creatine supplementation on single-effort sprint performance in elite swimmers. Int J Sport Nutr. 1996;6:222–33.
Pearson DR, Russel DGHW, Harris T. Long-term effects of creatine monohydrate on strength and power. J Strength Cond Res. 1999;13:187–92.
Volek JS, Duncan ND, Mazzetti SA, et al. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc. 1999;31:1147–56.
Volek JS, Kraemer WJ, Bush JA, et al. Creatine supplementation enhances muscular performance during high-intensity resistance exercise. J Am Diet Assoc. 1997;97:765–70.
Chrusch MJ, Chilibeck PD, Chad KE, et al. Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc. 2001;33:2111–7.
Kelly V, Jenkins DG. Effect of oral creatine supplementation on near-maximal strength and repeated sets of high-intensity bench press exercise. J Strength Cond Res. 1998;12:109–15.
Selsby JT, DiSilvestro RA, Devor ST. Mg2+-creatine chelate and a low-dose creatine supplementation regimen improve exercise performance. J Strength Cond Res. 2004;18:311–5.
Herda TJ, Beck TW, Ryan ED, et al. Effects of creatine monohydrate and polyethylene glycosylated creatine supplementation on muscular strength, endurance, and power output. J Strength Cond Res. 2009;23:818–26.
Stone MH, Sanborn K, Smith LL, et al. Effects of in-season (5 weeks) creatine and pyruvate supplementation on anaerobic performance and body composition in American football players. Int J Sport Nutr. 1999;9:146–65.
Zuniga JM, Housh TJ, Camic CL, et al. The effects of creatine monohydrate loading on anaerobic performance and one-repetition maximum strength. J Strength Cond Res. 2012;26:1651–6.
LeLorier J, Gregoire G, Benhaddad A, et al. Discrepancies between meta-analyses and subsequent large randomized, controlled trials. N Engl J Med. 1997;337:536–42.
Bogdanis GC, Nevill ME, Lakomy HKA, et al. The effects of oral creatine supplementation on power output during repeated treadmill sprinting. J Sports Sci. 1996;14:65–6.
Urbanski RL, Vincent WJ, Yaspelkis BB. Creatine supplementation differentially affects maximal isometric strength and time to fatigue in large and small muscle groups. Int J Sport Nutr. 1999;9:136–45.
Dempsey RL, Mazzone MF, Meurer LN. Does oral creatine supplementation improve strength? A meta-analysis. J Fam Pract. 2002;51:945–51.
Branch JD. Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab. 2003;13:198–226.
Nissen SL, Sharp RL. Effect of dietary supplements on lean mass and strength gains with resistance exercise: a meta-analysis. J Appl Physiol. 1985;2003(94):651–9.
Frédéric Dutheil contributed to the conception and design; Charlotte Lanhers conducted all literature searches and collated the abstracts; and Charlotte Lanhers and Frédéric Dutheil separately reviewed the abstracts and, based on the selection criteria, decided on the suitability of the articles for inclusion. All authors then reviewed the eligible articles. Frédéric Dutheil and Bruno Pereira performed the statistical analysis; Charlotte Lanhers drafted the manuscript; and Frédéric Dutheil and Geraldine Naughton revised the manuscript. All authors read and approved the final manuscript.
No sources of funding were used to assist in the preparation of this article.
Conflict of interest
Charlotte Lanhers, Bruno Pereira, Geraldine Naughton, Marion Trousselard, François-Xavier Lesage, and Frédéric Dutheil declare that they have no conflicts of interest relevant to the content of this review.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Lanhers, C., Pereira, B., Naughton, G. et al. Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis. Sports Med 47, 163–173 (2017). https://doi.org/10.1007/s40279-016-0571-4