Athletes put a lot of stress and strain on their bodies, which may lead to either positive or negative consequences. Just the right amount of stress during training is necessary to stimulate adaptation and increase performance. Nonetheless, physical trauma and extensive wear and tear of the body* may lead to injuries and pain. Current medical options available for treating pain and inflammation are effective, but they come with grave side effects, including death.

As a result, many people have been asking about cannabidiol or CBD for athletes in a bid to find better pain relief and recovery from sports related injuries. Well, should they?(well, are they onto something or not?) I hear you ask.

Prolonged use of over the counter pain relievers such as naproxen sodium and ibuprofen pose greater health risks than it was previously thought. Moreover, the country is currently struggling with an epidemic of opium addiction and overdoses that lead to tens of thousands of deaths every year.

In such a backdrop, it is understandable why athletes are both curious and eager to try this new alternative that promises pain relief and reduced inflammation without any of the risks that come with opioids or NSAIDS.

So, are CBD products right for athletes? This question has a multifaceted answer and I suggest you get comfortable* and read on.

CBD 101 – The Basics

Before going any further, you could be asking yourself, what is this CBD, what does it do in the body and why would I even consider using it?

Well, for starters, cannabinoids with similar chemical structures to CBD occur naturally in the body. Israeli scientists recently discovered what is now called the endocannabinoid system (ECS) that regulates the activities of neurons and various organs in the body.(9)

Cannabidiol (CBD) is a phytocannabinoid (plant-derived) that naturally occurs in the cannabis plant. Unlike tetrahydrocannibinol (THC), the other phytocannabinoid found in the same plant, CBD is not psychoactive.

That being said, the knowledge of how the ECS works and how CBD affects this function is still evolving. For a long time, research with regards to CBD was difficult to the legal status of cannabis. Nonetheless, according to recent studies, including the book The Essentials of Pain Medicine (4th Ed), here is what we know(5):

How the ECS works (brief summary)

Your nervous system produces two endocannabinoids (anandamide and 2-AG) in the postsynaptic neurons (downstream), which are then released into the synapse. These compounds then bind to CB1 and CB2 receptors on the presynaptic neurons which then act to inhibit the release of specific neurotransmitters.

For example, during the treatment of epilepsy using CBD, it is observed to reduce seizure activity partly by reducing the accumulation of glutamate, which is an excitatory neurotransmitter.

CB1 receptors are found throughout the brain and the central nervous system. CB2 receptors can be found in the brain and CNS, but more of them exist in tissues related to the immune system such as the spleen and **.

When CBD binds to CB1 receptors, its effects are mostly felt on the CNS. On the contrary, when it binds to CB2 receptors, it has more effect on reducing inflamed tissues.

  So far, the main function of the ECS seems to be maintaining homeostasis (physiological balance*), a feat it achieves mainly by keeping the levels of neurotransmitters in check. Taking CBD can be thought of enhancing or supplementing the activity of your already existing endocannabinoid system.

On average, athletes apply more stress and strain on their bodies, which may lead to more pain and inflammation than what the endocannabinoid system is able to handle. When your ECS is this overloaded, adding CBD may help get your neurotransmitters back under control and thus help athletes improve their health in general (improve homeostasis).

Is CBD Legal for Athletes?

Yes. The World Anti Doping Agency (WADA) removed CBD from the list of banned substances since the beginning of 2018, whether in or out of competition. You can view WADA’s banned list here. Moreover, the US Anti Doping Agency (USADA) also removed CBD from the prohibited list.

There is an important catch however: only CBD was removed from the list. Other natural cannabinoids from the hemp or marijuana plants such as the psychoactive THC, synthetic cannabinoids and other cannabimimetics are still banned from competitions.

Conspicuously, WADA set the urinary limit for THC as 150 nanograms per milliliter, which is ten times more than the previous threshold of only 15 nonograms per milliliter. The higher threshold was established to lower the risk of athletes testing positive due to limited use outside of competitions.

According to Ben Nichols, a spokesperson for WADA, statistics show that many cases of athletes testing positive do not involve game or event-day consumption. The new threshold is an attempt to detect in-competition use and leave out use during the weeks and days before an event.

When it comes to the legality of CBD outside of sports, CBD was recently desclassified from the list of illegal substance by the FDA and is now federally legal. Nonetheless, the federal, state and local laws surrounding CBD are constantly evolving. We recommend you check the laws in your location.

** Benefits of CBD for Athletes

Over the past few yeasr, CBD has gone mainstream due to its wide range of therapeutic effects. Athletes can especially benefit from CBD, here is how:

Pain relief

Studies have shown that CBD

The current research shows that CBD is a very potent pain reliever, so much so that scientists are considering it as a possible novel class of treatment for chronic pain. CBD’s pain reducing properties are highly attributed to its anti-inflammatory properties.

This compound has been found effective in reducing nerve-related pain by inhibiting the pain signals fired by the affected cells.

According to Andrew Talasky, a professional triathlete, he does not smoke marijuana, but he is being sponsored by Floyd’s of Leadville, a cannabis brand. He uses their CBD softgels to reduce chronic aches, pain and other competition-related stress. Andrew is not the only sportsperson experimenting with CBD before, during and after games.

However, more evidence is required to approve* the huge anecdotal evidence and biological plausibility of CBD before it can replace the current pain medication.

CBD may be a better alternative to NSAIDS

For decades now, athletes have been taking over-the-counter non-steroidal anti-inflammatory drugs such as naproxen sodium (Aleve) and ibuprofen (Advil). However, these drugs may not be as safe as once believed.

Long-distance athletes, especially, are advised to keep off* NSAIDs during intensive training sessions or events such as marathons since they increase the risk of renal damage. But even if your competitions and training sessions are short, NSAIDs increase your potential of having a stroke or heart attack.

Some athletes report that the pain-relieving effects of CBD enables them to reduce or even eliminate the use of NSAIDs with regards to pain caused by exercise. Moreover, CBD does not contain any serious adverse effects. According to ***, CBD is well-tolerated in both humans and animals, even at extremely high dosages.

CBD as an alternative to opioids

According to data from the CDC, opioids were responsible for the deaths of 42,000 Americans in 2016. Opioid pain medications such as codeine oxycontin and morphine are highly effective when it comes to managing pain. Nonetheless, they carry a huge risk of substance addiction and death as a result of overdosing.

Though not as effective as opioids for relieving high-intensity and acute pain (5), CBD may be more effective in managing pain over a long time. This can be either alone or in conjunction with other treatments, with no risk of dependence or accidental deaths.

Reducing inflammation

A little inflammation in the tissues of an athlete is necessary since it helps in muscle growth and stimulate positive training adaptations. On the other hand, too much inflammation prevents proper recovery and reduces performance.

As mentioned earlier, CB2 receptors can be found in the CNS but are more concentrated in immune tissues. CBD binds to these receptors, thereby decreasing inflammation by reducing the production and release of inflammatory cytokines (cell messengers). In other words, CBD reduces the response of your immune system after hard work outs which lead to less inflammation.

CBD is also able to inhibit the release of inflammatory macrophages which in turn reduce chronic inflammation. These same cell messengers are responsible for causing allergies, autoimmunity and hypersensitivity.

Reducing game day anxiety

The stress arising from the pressure to do well during a competition is often a source of great anxiety for athletes. Fear and anxiety are normal techniques that we adapted to cope with stress. However, excessive and persistent anxiety may lead to poor athletic performance.

Unfortunately, most anxiety treatments in the market right now normally result in drowsiness or mild to moderate sedative effects. These side effects can be highly detrimental to the performance of an athlete.

In comparison, recent studies show that CBD is capable of reducing anxiety without any adverse side effects. CBD reduces anxiety by boosting serotonin levels and eliciting an anti-depressant effect in mammals. Moreover, it achieves this feat faster than common prescription drugs for anxiety and can be taken daily as a supplement.

The overall sense of relaxation that you get after taking CBD oil for a while can help athletes focus better during the match and hence increase performance.

Settling digestive issues

Inflammation in the gut can cause a lot of discomfort, and gastrointestinal distress is one of the main reasons why endurance athletes drop out from races.

CBD will not help with stomach upsets caused by overheating and dehydration – the two major culprits in the case of athletes. However, if you have any underlying gut issues due to inflammation, then CBD may be able to help with your symptoms.

Based on results from numerous studies, CBD can help regulate digestion and bowel movements, hence improving the health whole gastrointestinal tract.

Improved sleep quality

Getting enough and quality sleep is one of the most effective natural ways athletes can utilize to boost their performance in the field.  According to anecdotal reports*, athletes who use CBD report falling to sleep with greater ease as well as a more restful sleep at night.

According to science, this could be due to CBD’s effect of inhibiting the reuptake of adenosine.(7) You see, your brain normally breaks down sugar into energy, and in the process breaks it down adenosine triphosphate (ATP) to form adenosine.

The adenosine accumulates in the brain gradually, binding to free neurons, which in turn inhibits the release of neurotransmitters. This slows down your brain activity, making you feel calm and sleepy.

As you sleep, the accumulated adenosine gets broken down. You wake up when the levels of adenosine drop below a certain level, then the whole process starts all over again.

By binding to the same receptors that adenosine binds to, CBD prevents the reuptake of adenosine, making it buildup of adenosine to happen much quicker in the brain and hence making you sleepy sooner.

Moreover, with its anti-anxiety properties, CBD helps you calm down, which makes it easier to catch some quality sleep.

How do I take CBD oil?

If you care to check, you’ll find that there is a multitude of CBD products online and new ones are hitting the market every week. CBD can be ingested as a pill, capsule or tincture/drops of CBD oil that are placed under the tongue.

It can also be applied topically as a cream/lotion or be inhaled as a vapor. CBD can now be found in sports drinks, recovery beverages and all kinds of edibles.

As you can see from this article*, how you consume CBD can affect how quickly and intensely you feel the results. Generally, any form of CBD that has to pass through the lengthy digestive tract may take a bit longer for the effects to show up*. Sublingual drops are said to be one of the fastest methods and for fastest results, then inhalation through vaping is the answer.

Generally*, CBD is sold either as an “isolate”, or as “full-spectrum”. Full-spectrum CBD contain other cannabinoids, terpenes and even flavors found in the original plant. This means that they could contain trace amounts of THC. Legally, only CBD derived from hemp is considered legal since hemp normally contains less than 0.3% THC.

For athletes, CBD isolates and CBD extracted from the hemp planet would be a wiser choice for anyone with zero tolerance for testing positive in a drug test at work.

Choose your CBD carefully*

According to a JAMA study published in November 2017, the CBD market is rife with mislabeled products. The authors reported that 69% of the products they evaluated contained different amounts of CBD from what was written on the label.

Moreover, 21% of the products tested positive for THC, with some containing enough levels to cause impairment. As mentioned earlier, THC has a urine*(reporting) threshold of 150ng/mL. this means that even if WADA finds THC in your system but below this level, it won’t be considered an infringement of the rules.

If an athlete is able to get their hands on CBD that is very low on THC or if they stop their CBD intake in time for the THC to clear from their system, then its use is nothing to worry about.

To make sure that you are buying quality products and that what is written on the label is what is inside the container, do some research about the company and people about the products. More importantly, ask for a certificate of ** from an independent third-party lab to verify these claims.

How much CBD do I take?

When it comes to the question of how much CBD to take, things are not so straight forward. Many factors come into play. For instance, the condition you are trying to treat, your age, gender, metabolism,(link)etc. Moreover, since CBD products are not as strictly regulated as medical products, there can be inconsistencies depending on where you buy your CBD.

Here at GFB, we have a simple method we call the Stepwise Dosing Procedure that helps you get the most out of your CBD. In short, it helps you establish a tailored dose by starting you on a baseline dose and gradually increasing until the optimum dose where you are getting the best results with least side effects if any.

Conclusion

The rise of cannabidiol holds the potential to revolutionize how athletes recover from training stress as well as how they manage occasional and chronic pain. The only drawback is that currently, there is still a lot to learn about how CBD works and how athletes can get the best results from it.

Nevertheless, with what science has established so far, CBD offers great potential benefits with few risks involved. It is a powerful pain reliever that can improve recovery in athletes, not to mention its potency to reduce inflammation and induce better sleep quality. Moreover, if CBD can replace or at least reduce the consumption and dependence of athletes on opioids and NSAIDs, then that is even better* news.

Although legal in and out of sports, it is risky for athletes to buy untrustworthy CBD products since some do not contain what is specified on the label. If it contains high levels of THC or other prohibited compounds, you are at risk of infringing on doping regulations. As with anything meant to go inside your body, it will be up to you to do the necessary research and establish a reputable source.

References & Resources

  1. Booz, George W. “Cannabidiol as an Emergent Therapeutic Strategy for Lessening the Impact of Inflammation on Oxidative Stress.” Free Radical Biology and Medicine, vol. 51, no. 5, 2011, pp. 1054–1061., doi:10.1016/j.freeradbiomed.2011.01.007.
  2. Elman, Igor, and Scott E. Lukas. “Effects of Cortisol and Cocaine on Plasma Prolactin and Growth Hormone Levels in Cocaine-Dependent Volunteers.” Addictive Behaviors, vol. 30, no. 4, 2005, pp. 859–864., doi:10.1016/j.addbeh.2004.08.019.
  3. Filippis, Daniele De, et al. “Cannabidiol Reduces Intestinal Inflammation through the Control of Neuroimmune Axis.” PLoS ONE, vol. 6, no. 12, 2011, doi:10.1371/journal.pone.0028159.
  4. Gorzalka, Boris B., et al. “Regulation of Endocannabinoid Signaling by Stress: Implications for Stress-Related Affective Disorders.” Neuroscience & Biobehavioral Reviews, vol. 32, no. 6, 2008, pp. 1152–1160., doi:10.1016/j.neubiorev.2008.03.004.
  5. Halawa, Omar I., et al. “Role of Cannabinoids in Pain Management.” Essentials of Pain Medicine, 2018, doi:10.1016/b978-0-323-40196-8.00056-5.
  6. Hammell, D.c., et al. “Transdermal Cannabidiol Reduces Inflammation and Pain-Related Behaviours in a Rat Model of Arthritis.” European Journal of Pain, vol. 20, no. 6, 2015, pp. 936–948., doi:10.1002/ejp.818.
  7. Murillo-Rodriguez, Eric, et al. “Anandamide Enhances Extracellular Levels of Adenosine and Induces Sleep: An In Vivo Microdialysis Study.” Sleep, vol. 26, no. 8, 2003, pp. 943–947., doi:10.1093/sleep/26.8.943.
  8. Nagarkatti, Prakash, et al. “Cannabinoids as Novel Anti-Inflammatory Drugs.” Future Medicinal Chemistry, vol. 1, no. 7, 2009, pp. 1333–1349., doi:10.4155/fmc.09.93.
  9. Pacher, P. “The Endocannabinoid System as an Emerging Target of Pharmacotherapy.” Pharmacological Reviews, vol. 58, no. 3, 2006, pp. 389–462., doi:10.1124/pr.58.3.2.
  10. Patricia H. Reggio, “ Endocannabinoid Binding to the Cannabinoid Receptors: What Is Known and What Remains Unknown”, Current Medicinal Chemistry (2010) 17: 1468. https://doi.org/10.2174/092986710790980005
  11. Xiong, Wei, et al. “Cannabinoids Suppress Inflammatory and Neuropathic Pain by Targeting α3 Glycine Receptors.” The Journal of Experimental Medicine, vol. 209, no. 6, 2012, pp. 1121–1134., doi:10.1084/jem.20120242.

Pascal Magero