Creatine, and getting up off the floor

There is a test buried in this study that nobody puts on a supplement label. Getting up from lying on the floor. It is timed, it is undignified, and it is close to the most honest measure there is of whether an older body still does what its owner needs it to do.

Anyone who has treated a person in their seventies after a fall knows that the floor itself is rarely the injury. The floor is what happens next. Whether you can get off it under your own power decides an ambulance call, a hospital week, and sometimes the whole shape of the following year.

So a study that measures that, in women, and finds something that moves it, is worth reading properly.

What they did

Researchers at North University of Parana in Brazil, publishing in the European Journal of Applied Physiology, recruited eighteen healthy women aged between sixty and eighty, average age just under sixty-five. None were athletes. None had trained systematically in the previous six months. None were vegetarian, which matters more than it sounds: vegetarians carry less creatine in muscle to begin with and tend to respond differently, so including them would have muddied the result.

It was randomised and double blind. Nine women took five grams of creatine a day. Nine took maltodextrin, a placebo that mixes and tastes near enough the same. Neither the women nor the people running the tests knew who had which.

Both groups then did the identical twelve week programme. Eight exercises covering the whole body, three days a week, built to add strength and size.

One number explains all the others

That is the whole mechanism in a sentence. Creatine does not build muscle. It funds the effort that builds muscle. It sits in muscle as phosphocreatine and regenerates energy fast during short maximal work, which buys the extra repetition, and then the extra repetition after that. Over twelve weeks those repetitions accumulate into something visible.

Which is why the rest of the results follow so neatly.

What twelve weeks bought

Each of these is the creatine group's own improvement, and each was larger than what the placebo group managed on the same programme:

• One repetition maximum on bench press, up 5.1 percent
• Knee extension, up 3.9 percent
• Biceps curl, up 8.8 percent
• Fat free mass, up 3.2 percent
• Muscle mass, up 2.8 percent, measured by DEXA rather than a tape measure

And now the part that tends to settle the argument in a treatment room. Body mass did not change. Percentage body fat did not change. Not in the creatine group, not in the placebo group.

Nearly every woman over sixty who is offered strength work asks some version of the same question, which is whether this is going to make her bulky, or heavier, or somehow less like herself. Here is a study where the scale did not move and the strength did.

Back to the floor

Alongside the lifting numbers they ran three everyday tasks: the thirty second chair stand, which is how many times you can rise from a chair and sit back down in half a minute, an arm curl test, and getting up from lying on the floor.

On these submaximal tasks, the ones that are not about a single heroic effort but about ordinary competence, the creatine group became measurably more efficient than the placebo group. The paper reports the difference as efficiency on submaximal strength tasks rather than publishing a headline number for each, so that is as far as the claim goes here.

Still, look at what those three tests are. Standing up. Lifting something. Getting off the floor. That is not fitness. That is independence, broken into its parts and timed.

What this study cannot tell you

How this gets used in practice

The order is not negotiable, and it is the opposite of how supplements are usually marketed. The programme is the intervention. Creatine is an adjunct that makes the programme go further. Reverse those two and you have bought a tub of powder and a placebo effect.

The training in this study was ordinary and repeatable. Eight exercises, whole body, three times a week, loaded properly and progressed. No wobble boards, no gadgets, no proprietary system. It is close to what any competent gym programme for an older adult already looks like, which is reassuring rather than disappointing.

There is a second reason creatine keeps coming up for women past menopause, and it is not about muscle at all. The evidence on creatine and bone is covered separately in what creatine does to bone after menopause, where the same supplement is doing something quite different and the caveats are different too.

Whether five grams a day is appropriate for any particular person, alongside whatever else they take and whatever their kidneys are doing, is a conversation with a clinician who has seen their bloods, not a conclusion to draw from a study of eighteen strangers.

Linda competes in the seventy plus division at CrossFit, against her own age group. What she does there is loaded, controlled movement through range, three times a week, progressed over years. The programme in this paper is a twelve week version of the same idea, offered to women who had never trained at all, and it moved their ability to get up off the floor.

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