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Creatine for neurological rehabilitation: Could it have value as a supplement?

Creatine monohydrate is the most studied supplement in sport, with a safety record few products can match. From time to time, someone living with a spinal cord injury, or a therapist working with neurological clients, asks me about it: if it builds muscle and improves performance in athletes, would it help someone rebuilding strength after a neurological injury? It is an interesting question.

This article works through what the research shows, its limitations, and what that means in practice. The short version is that the evidence in healthy and older adults is strong, the evidence in neurological rehabilitation is thin and mixed.

One point before we begin. Creatine is a food supplement, not a medicine, and nothing here is individual medical advice. If you have kidney problems, take other medication, or have a complex medical picture, speak to your doctor or a dietitian before starting anything. With that said, let us look at the evidence.

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tSCS, Spasticity, spinal cord stimulation, Stim2Go Derek Jones tSCS, Spasticity, spinal cord stimulation, Stim2Go Derek Jones

When Spasticity Gets in the Way of Standing

For some people, the obstacle to standing up is not weakness. It is the opposite problem: legs that are too stiff, too tense, or too unpredictable to cooperate. You go to move and the leg pushes out straight when you wanted it to bend, or a spasm arrives at the worst possible moment, or simply getting your feet into a sensible position feels like a negotiation. This is spasticity, and for a great many people, after an incomplete spinal cord injury or stroke, it is the single thing standing between them and a useful sit-to-stand.

We have written before about spasticity after spinal cord injury and the limits of medication. This article looks at a more specific question: when spasticity is the thing blocking a functional goal like standing, what can electrical stimulation do about it, and how do the pieces fit together?

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One Device, Many Exercises: Getting More From a Single Stimulator

One of the quieter worries in rehabilitation is rarely about the therapy itself. It is about money. Equipment is expensive, budgets are tight, and funding is often uncertain until late in the process. The fear we hear most is not "will this work," but rather "will I spend a significant sum and end up with the wrong thing, or with several things that do not work well together." Does this sound familiar?

It is a reasonable worry, and it deserves a straight answer rather than a sales pitch. This article looks at one practical way of reducing that risk: choosing a single, flexible stimulator that covers several rehabilitation needs, rather than a separate machine for each. The device we have in mind is the Stim2Go, and the point is not so much the brand as the principle behind it.

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Standing Up Again: How Responsive Electrical Stimulation Can Support Sit-to-Stand Practice

Ask someone in the early stages of recovery from a spinal cord injury or stroke what they most want to do again, and the answers are often smaller and more specific than you might expect. Not "run a marathon." More often, it is something like rising from a chair without help, managing a transfer to the bed, or pushing up to standing so that getting to the toilet is your own business and nobody else's.

Sit-to-stand sits at the centre of all of that. It is one of the most important movements in daily life and one of the first functional milestones a therapist will work on. If you can move reliably between sitting and standing, a great deal of independence follows. This article looks at how electrical stimulation, and in particular a responsive electrical stimulation device like the Stim2Go, can support sit-to-stand practice as part of a wider rehabilitation programme.

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Waveform matters: what new evidence tells us about transcutaneous spinal cord stimulation

Transcutaneous spinal cord stimulation (tSCS) has moved quickly from a research curiosity to a recognised tool in neurological rehabilitation. People living with spinal cord injury, stroke, and multiple sclerosis are asking us about it. Clinicians want to know which device to recommend. Equipment commissioners want evidence-led guidance before authorising spend that can run into tens of thousands of pounds per system.

A paper published in Nature Biomedical Engineering on 12 May 2026 has added something important to that conversation. It is not a clinical trial. It is a careful study of the physics and physiology that govern which nerve fibres a tSCS device actually recruits. The finding is consequential, and it bears directly on the choice of device.

In short: the waveform you choose determines whether tSCS does the thing rehabilitation needs it to do.

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PRAFO, Pressure Ulcers Derek Jones PRAFO, Pressure Ulcers Derek Jones

Floating Heels: What the 2025 International Pressure Injury Guideline Means for the PRAFO

Heel pressure injuries are one of those problems where the evidence has been ahead of everyday practice for years. We have known for many years that pillows and improvised supports rarely keep a heel clear of the bed for long, and that a heel touching anything is a heel under pressure and shear. The 2025 International Pressure Injury Guideline (the fourth edition produced by NPIAP, EPUAP, and PPPIA) has now caught up to that reality, and in doing so it has changed the language clinicians and commissioners should use when they think about heel protection.

The guideline introduces a phrase worth noticing: "floating heels."

It is not a marketing line. It is a clinical description of what an effective heel offloading intervention has to achieve, taken from the guideline itself. And it has practical implications for any service that has to choose, fund, or audit heel protection equipment.

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