Athletes put a lot of stress on their bodies, with positive and negative effects. Exercise stress promotes adaptation and performance improvement, but physical strain and prolonged wear and tear also lead to injury and pain. Current methods of treating pain, while effective, are not safe either. In search of better athletic recovery and safer pain relief, many people ask about cannabidiol, or CBD for athletes. Should you?
Chronic use of over-the-counter pain relievers (i.e. NSAIDs like ibuprofen and naproxen sodium) poses a greater health risk than previously known, and we are in the midst of an epidemic of opioid addiction and overdoses that kill tens of thousands of people annually. With this in mind, athletes are rightly curious and excited about cannabidiols (CBD), which promise pain relief and anti-inflammatory measures without the risks associated with NSAIDs or opioids.
Are CBD Products Right For You? There's a lot to clarify and consider here, so make yourself comfortable and read on.
Is CBD Legal For Athletes?
Yes. Since the beginning of 2018, the World Anti-Doping Agency (WADA) removed CBD from the list of prohibited substances - in or out of competition. The US Anti-Doping Agency (USADA) has done the same and has a "Marijuana FAQ" page to explain the rules. There is one important caveat: ONLY CBD has been removed from the Prohibited List. The psychoactive component of marijuana, THC, is still banned in competition, as is synthetic cannabinoids. The exact wording is: “All natural and synthetic cannabinoids are prohibited, e. E.g .: in cannabis (hashish, marijuana) and cannabis products. Natural and synthetic tetrahydrocannabinols (THCs). Synthetic cannabinoids that mimic the effects of THC. Except: cannabidiol. "
Interestingly, the WADA the limit for THC in urine has been set at 150 nanograms per milliliter, which represents a significant relaxation compared to the previous limit of 15 nanograms per milliliter. The higher limit is intended to reduce the risk that an athlete will test positive due to occasional use outside of competitions. A 2016 USA Today article quoted Ben Nichols, a spokesman for WADA, as saying, “Our information suggests that many cases are not due to use during a game or event. The new threshold is an attempt to ensure that use is recognized during the competition and not use in the days and weeks prior to the competition. "
As for legality outside of sport, that's a whole different matter. The legality of cannabis and related products at the federal, state, and local levels is constantly evolving. Find out about the laws in your area.
Athletes can legally consume cannabidiol, but what is it, what does it do, and why should you use it?
First of all, cannabinoids are already present in your body. Scientists have identified what is known as the endocannibinoid system (ECS), which modulates the activity of neurons. Cannabidiol (CBD) is a phytocannabinoid that occurs naturally in the cannabis plant. Unlike THC, which is also found in cannabis, CBD is not psychoactive.
Additionally, scientists' understanding of how the ECS works and how CBD affects it is still evolving. For a long time, research in this area was difficult due to the legal status of marijuana. Based on recent studies and the 2018 book The Essentials of Pain Medicine, Fourth Ed. however, the basics are listed here.
In your nervous system, two endocannabinoids (2-AG and EAE) are produced in postsynaptic neurons (downstream) and released into the synapse. They bind to CB1 and CB2 receptors on the presynaptic neuron (upstream) and inhibit the release of certain neurotransmitters. For example, when used to treat epilepsy, CBD can reduce seizure activity by - in part - reducing the build-up of glutamate, an excitatory neurotransmitter.
CB1 receptors are found all over the brain, spinal cord, and other tissues. CB2 receptors are also present, but more of them are found in immune system tissues. CBD that binds to CB1 receptors has a stronger effect on the central nervous system, and CBD that binds to CB2 receptors has a stronger effect on reducing inflammation.
The main purpose of the ECS appears to be to maintain homeostasis by keeping neurotransmitter levels under control. Ingesting CBD could be viewed as a supplement or increase in the activity of the body's endocannabinoid system.
As an athlete, you put more stress on your body, causing pain and inflammation that your endocannabinoid system cannot handle. Adding exogenous CBD can help this overloaded system bring neurotransmitters back under control and help athletes maintain homeostasis.
6 benefits of CBD for athletes
Studies have shown that cannabis (mainly THC and far less CBD) is effective in relieving pain, including musculoskeletal pain during exercise, and stiff joints. There is little research on CBD alone or on a 1: 1 ratio of THC to CBD. This is an area where anecdotal evidence and biological plausibility are the best we have until research catches up with the backlog. Despite the lack of solid evidence, CBD appears to provide effective pain relief for many athletes.
Alternative to NSAIDs
Athletes have been taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen sodium (Aleve) for decades, but they may not be as safe as we once thought. Ultra-distance athletes in particular are usually advised to avoid NSAIDs during long training sessions and competitions, as they are at increased risk of kidney damage. But even if your workouts and competitions are short, long-term or frequent use of NSAIDs can increase your risk of heart attacks and strokes.
Some athletes have found that the analgesic effects of CBD can reduce or even eliminate the use of NSAIDs for exercise-related pain, with minimal side effects. According to The Essentials of Pain Medicine, Fourth Ed. there are no documented deaths from cannabis or cannabinoid-based products. In a systematic review of studies of oral and oral mucous cannabis in various diseases, the majority of the reported adverse events were classified as non-serious (96,6%). "
Alternative to opioids
According to the CDC, opioids were involved in more than 2016 deaths in the United States in 42.000. Opioid pain relievers (e.g. morphine, codeine, oxycontin) are highly effective in treating pain, but carry a significant risk of addiction and death from overdose. Cannabinoids are not as effective as opioids in relieving acute, severe pain, but can be effective in long-term pain management, either alone or in conjunction with other medications, with a far lower risk of addiction or accidental death.
A little inflammation can be good for athletes and help make positive training adjustments. Too much inflammation hampers recovery and affects performance. CB2 receptors are found both in the brain and in the periphery, but they are more concentrated in the tissues of the immune system. Cannabinoids that bind to CB2 receptors can have anti-inflammatory effects by reducing the production of cytokines (cell messengers). In other words, CBD bound to CB2 receptors helps dampen the response when the immune system sounds the alarm after hard exercise.
Calm your bowels
Inflammation in the small and large intestines causes a lot of discomfort, and gastrointestinal discomfort is one of the main reasons endurance athletes drop out of competitions. While CBD won't solve stomach problems caused by dehydration or overheating (two major causes for athletes), if you have underlying inflammation problems that contribute to bowel problems during or after exercise, CBD can be effective at relieving your symptoms. There are CB1 and CB2 receptors in the colon. Colitis symptoms were inhibited (in mice) when CB1 and CB2 receptors were activated.
Improve the quality of sleep
Getting more and better sleep is one of the most effective ways an athlete can achieve greater exercise success. Anecdotally, athletes who consume CBD report that they fall asleep more easily and sleep more restfully. One possible reason for this could be that CBD inhibits the reuptake of adenosine.
Adenosine triphosphate (ATP) breaks down when the brain burns carbohydrates for energy, and adenosine gradually builds up in the brain. More adenosine that binds to the neurons inhibits the release of neurotransmitters, slows down brain activity, helps you feel calmer, and leads to sleep. The body breaks down adenosine while you sleep, and some time later, low levels of adenosine help you wake up and the process starts all over again.
By binding to the same receptors that adenosine binds to, CBD can inhibit the reuptake of adenosine, making it build up faster and making you feel sleepy faster. CBD can also have powerful anti-anxiety effects in some people, which can help them fall asleep and have more restful sleep.
How to use CBD
New products containing CBD hit the market every week. You can get CBD in capsule form, crystals, Buds, Take pills or as an oil. You can inhale it as a vapor. It has been used in sports drinks, recreational drinks, and all types of edibles. There are also creams and lotions that do CBD Oil as well as tinctures / drops that can be placed under the tongue.
The way you consume CBD can affect how quickly you feel the effects. Capsules, oil, and edibles need to be digested first, so they can take a little longer. Topical creams are said to work faster than edibles, and sublingual drops / tinctures are said to work the quickest (besides inhalation by evaporation).
CBD is available as a "full spectrum" or "isolate". Full-spectrum CBD products contain CBD and other compounds found in the original plant, which may also contain small amounts of THC. If the CBD was obtained from industrial hemp, the law requires the THC content of the original plant to be less than 0,2%. Products containing CBD isolate should only contain CBD. From an anti-doping perspective, CBD isolate and hemp-derived CBD would be the better choice for anyone who does not carry out doping controls at work (e.g. pilots).
How Much CBD to Use
This is where it gets tricky. There is no one standard dose that works consistently in all people. CBD products are not well regulated, so there can be inconsistencies in the amount of CBD in a product. And depending on how you consume CBD (oil, gummy bears, cookies, recovery drink, tincture, steam) it can be difficult to be specific. Probably the most accurate way to consume CBD is by taking capsules or calculating how many milligrams of CBD are in a given volume (e.g. 1 milliliter) of a tincture.
Companies that make and sell CBD products recommend starting with a low dose and gradually increasing it based on the effects you feel.
Conclusion and warning
The advent of cannabidiol could mark a major turning point in the way athletes recover from exercise loads and manage both occasional and chronic pain. The huge, blatant caveat is that the use of CBD and the way it's administered are ahead of science at the moment. There is still a lot to learn about how CBD works and how it can best be used in athletes. However, this is not uncommon. When the first high-carb sports drinks hit the market, it was clear that even if the formulas weren't perfect and the mechanisms weren't fully understood, they would help improve performance.
While it is not a prohibited substance for athletes, whether in or out of competition, the potential risk for athletes is that the product they are purchasing does not contain what is on the label. If it actually contains a significant amount of THC or other prohibited substance, there is a risk of a doping violation. As with all other products, your job is to do your research and find a reputable brand.
With what we currently know, CBD offers good potential benefits and few risks. If used as a pain reliever, anti-inflammatory, and sleep aid, it has great potential to improve recovery. And if it gets athletes to cut back on NSAIDS, opioids, and prescription sleeping pills, they'll be even greater accomplishments.