A physical rehabilitation program involving eccentric training, stretching, and ESWT is effective in reducing tendon thickness and increasing muscle strength, but the addition of creatine supplementation induces an earlier reduction of pain and a positive effect on CMJ performance in athletes with patellar tendinopathy.
Both creatine and placebo groups showed significant reductions in pain (VISA-P scores) over 8 weeks of physical rehabilitation.
Only the creatine group showed a statistically significant improvement in VISA-P pain scores at the midpoint (4 weeks), suggesting an earlier reduction in pain compared to placebo.
Both groups showed significant progressive improvements in tendon thickness over the 8-week intervention.
Both groups showed significant progressive improvements in knee extension strength (5-RM) over 8 weeks.
A trend toward a significant time × supplementation interaction was observed for countermovement jump (CMJ) performance, with improvements only in the creatine group.
The rehabilitation protocol consisted of daily eccentric training combined with stretching, extracorporeal shock wave therapy (ESWT) every 10 days, and manual therapy over 8 weeks.
This research suggests that a structured physical rehabilitation program — combining daily eccentric exercises, stretching, shock wave therapy, and manual therapy — is effective at reducing pain, decreasing tendon thickness, and improving knee strength in athletes with patellar tendinopathy (a common overuse injury of the knee). Both athletes who took creatine supplements and those who took a placebo improved significantly over the 8-week program, indicating that the rehabilitation itself is beneficial regardless of supplementation. However, this research also suggests that adding creatine monohydrate supplementation to rehabilitation may provide some additional benefits. Specifically, athletes taking creatine showed a significant reduction in pain at the 4-week midpoint, while placebo athletes did not reach that threshold until the end of the 8-week program. Additionally, only creatine-supplemented athletes showed measurable improvements in jump height (countermovement jump) during the rehabilitation period, pointing to a possible advantage in recovering explosive leg power. The study involved only 20 athletes and was relatively short in duration, so these findings should be considered preliminary. Nevertheless, this research suggests that creatine supplementation could be considered as an ergogenic (performance-enhancing) recovery aid to potentially accelerate pain reduction and maintain explosive performance in athletes rehabilitating from patellar tendinopathy, when combined with a structured physical rehabilitation program.
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Upload Your LabsSánchez-Gómez &, Malaguti M, Sañudo B, López-Samanes &, San Juan A, Domínguez R. (2026). Could creatine supplementation combined with physical rehabilitation accelerate return to play in athletes with patellar tendinopathy?. Journal of the International Society of Sports Nutrition. https://doi.org/10.1080/15502783.2026.2718846