Athletes and other performers live a life of chronic stress and fatigue - and then rebounding from this to perform again. Training itself is where most injuries occur according to statistics - and the mental and physical anguish of it all causes many to use substances that are approved for pain. Over the counter remedies are a key choice for many due to testing for cannabinoids - but for most in sports this is changing quickly due to CBD and the rapid global stance on the safety and ability to use it. 

Starting in early 2018, the World Anti-Doping Agency (WADA) removed CBD from the list of banned substances – in or out of competition. The US Anti-Doping Agency (USADA) did the same thing and provided the Marijuana FAQ page to explain the rules. There is a significant caveat: only the CBD has been excluded from the banned list. The psychoactive portion of marijuana, THC, is still banned in competition with synthetic cannabinoids. The precise terminology is: ‘Both natural and synthetic cannabinoids are forbidden, e.g. cannabis (hashish, marijuana) and cannabis products. Real and synthetic tetrahydrocannabinols (THC). 

WADA set a urinary threshold of 150 nanograms per milliliter for THC, which is considerably more lenient than the previous cap of 15 nanograms.  The higher threshold is intended to minimize positive athlete testing due to out-of-competition use. A USA Today article in 2016 quoted Ben Nichols, the WADA spokesperson, as saying, “Our knowledge indicates that many cases do not require game or event-day consumption. The new threshold standard is an attempt to ensure that in-competition usage is identified and not used during the days and weeks prior to competition."  All the way around their loosening the cannabinoid belt a few notches to allow for some room to use. 

A minor injury to most athletes is major to most of us, but when a performer gets seriously hurt the same addiction we all face over pain is now on their menu - Opioids. The number of sports related opioid overdoses is rising dramatically even with the amount of education moving about on the dangers of the drugs. Just like a cancer patient has more access - so does the superstar that just tore a ligament or was got hurt so bad they have no choice to be sidelined and watch their team - and that's when the dangerous drugs are often prescribed.

Chronic use of over-the-counter pain relievers presents a higher health risk than previously understood, and we are in the midst of an opioid abuse and overdose crisis that kills tens of thousands of Americans every year. In such a landscape, athletes are understandably interested and willing to see cannabidiols (CBDs) offer pain relief and decreased inflammation without the risks associated with NSAIDs or opioids. 

Cannabinoids, or endocannabinoids, already exist in our body to begin with. Scientists have established what they call the endocannabinoid system (ECS) that modulates neuron activity and more. The research in this field had been hard to do for quite some time because of prohibition of the plant and inability to research. For most, the basics from recent studies and 2018 The Fundamentals of Pain Medicine, Fourth Ed.,  will be enough to learn quite a bit.

Within our bodily system two endocannabinoids known as 2-AG and Anandamide are formed in post-synaptic neurons and released into the synapse. They bind to the presynaptic neuron receptors (cannabinoid receptors) CB1 and CB2 and act to inhibit the release of certain neurotransmitters.

CB1 receptors are located in the brain, spinal cord, and other tissues. CB2 receptors are also present, but most of them are located in the tissues of the immune system. CBD binding to CB1 receptors has a greater effect on the central nervous system, and CBD binding to CB2 receptors has a greater effect on the reduction of inflammation.

The primary aim of the ECS tends to be to preserve homeostasis, which it does by keeping the neurotransmitter levels in check. Consuming CBD may be thought of as complementing or growing the operation of your body ‘s current endocannabinoid system.

As an athlete, you place more stress on your body, leading to more discomfort and inflammation than your endocannabinoid system can manage. Adding exogenous CBD will help this overwhelmed mechanism to keep the neurotransmitters under control and help athletes maintain homeostasis.

Reduction of DOMS:  The society of cannabis clinicians team were published in the International Journal of International Journal of Physical Education, Sports, and Health on this very subject: Here's a quick synopsis of their ABSTRACT.    

Introduction: 

Exercise induced muscle damage (EIMD) can result in a condition commonly known as delayed onset of muscle soreness (DOMS). The influence the well-known anti-inflammatory effects of cannabidiol (CBD) can have on DOMS has yet to be determined. The aim of this study was to determine the influence CBD can have on EIMD DOMS. Materials and Methods: Twenty-three trained participants completed a lower extremity EIMD protocol prior to being randomly assigned to either a CBD, MCT or null group. Self-report visual analog scale (VAS) scores were used to determine the level of soreness the participant was experiencing throughout the study (pre-, post-EIMD protocol, 24-, 48-, 72- and 96-hours post-EIMD protocol). The CBD group was given a 1ml solution of CBD and MCT oil. This solution contained 16.67mg of CBD. The MCT group received 1ml of MCT. The null group received nothing.

Results: Each group reported significantly different post-EIMD VAS score when compared to pre-EIMD. The CBD group reported significant differences in VAS score at post-EIMD to 24-hours post-EIMD, at 48-hours post- EIMD and 72-hours post-EIMD. At 96-hours post-EIMD the CBD group reported VAS scores closer to pre-EIMD levels than either the MCT or null groups. Conclusions: CBD appears to have a significant influence on muscle soreness associated with EIMD DOMS when consumed immediately after strenuous exercise. Additionally, the rate of recovery with CBD use is greater when compared to MCT only or no intervention.  

Citation:

Hatchett A, Armstrong K, Hughes B, Parr B. The influence cannabidiol on delayed onset of muscle soreness. Int J Phys Educ Sport Heal. 2020;7(2):89-94.

 One of the best Alternatives to pesky over the counter anecdotes: 

Over-the-counter non-steroidal anti-inflammatory medications (NSAIDs ) such as ibuprofen  and naproxen sodium have been used by athletes for decades, but they may not be as effective as we once believed. Ultradistance athletes, in particular, are usually recommended to avoid NSAIDs during long training sessions and events due to an increased risk of kidney injury. But even if your workouts and events are short-term , long-term or repeated use of NSAIDs may increase your risk of heart attack and stroke.

 Some athletes have found that the pain-relieving effect of CBD can minimize or eliminate the use of NSAIDS for exercise-related pain with minimal side effects. According to The Fundamentals of Pain Medicine, Fourth Ed., ‘There are no reported deaths from cannabis or cannabinoid-based items. In a systematic study of oral and oral mucosal cannabis trials for different medical conditions, most adverse events were deemed minor - 96%."

Reduction of G.I. Inflammation: 

Inflammation in the small and large intestines causes a lot of pain, and GI pressure is one of the key reasons why endurance athletes fall out of races. CBD may not solve gastrointestinal issues due to dehydration and overheating (two main causes for athletes), but if you have underlying inflammatory problems that lead to intestinal problems during or after exercise, CBD can be effective in-the symptoms. CB1 and CB2 receptors are found in the colon. Colitis symptoms (in mice) were inhibited when CB1 and CB2 receptors were triggered. (8) 

 Improvement of sleep is an improvement of Athletic or any Performance:

Having more and more sleep is one of the most important ways for an athlete to receive more training. Anecdotally, CBD-consuming athletes show more ease of sleep and more restful night’s sleep. One plausible cause for this may be CBD inhibiting the reuptake of adenosine. (7) 

Adenosine triphosphate ( ATP) breaks down when your brain burns carbohydrate for energy, and adenosine steadily builds up in your brain. More adenosine binding to neurons prevents the release of neurotransmitters, slows down brain activity, makes you feel calmer and induces sleep. Your body metabolizes adenosine while you're sleeping, later, low concentrations of adenosine help you wake up and the process begins again. 

By binding to the same receptors that adenosine will bind to, CBD has the promise to inhibit adenosine reuptake -  and that makes you feel sleepy. CBD also has an anti-anxiety effect on certain people, and reducing stress and rapid thoughts as we lay down has great promise in gaining more restful sleep.

There is still a lot to learn about how CBD works and how it can best be used by athletes. Back when the high sugar and carbohydrate-rich sports drinks first appeared, it was obvious that they helped boost efficiency and energy even if the formulations were not perfect and the mechanisms were not all established. Quickly athletes learned those type of drinks would bog them down in the long run. 

Although it is not a restricted drug for athletes in or out of competition, the possible danger to athletes is that the product you purchase does not contain what it says on the bottle. If it actually contains a large amount of THC or other banned drug, you are at risk of a doping violation. As with everything else, it’s up to you to investigate and find a trustworthy brand.

With what we know at this point, CBD has strong potential with far less risk than over the counter and pharmaceutical substances. As research continues to quantify CBD acting as a promising new choice in recovery for DOMS, as a pain reliever, an anti-inflammatory, and also showing improvement in sleep there is a good chance we'll be seeing specified product lines that are far advanced for Athletes to use.

At GCRC, We work on this type of technology daily - advanced treatment for athletes and performers with the use of extremely condensed and efficacious delivery systems that can occur in seconds. The technologies that are being created to treat all types of performers and athletes 'on the spot' during a break, huddle, or time out is in the process of being created  - and it's beyond interesting. "It's like NASA made this or something - We need a new word that describes something beyond 'next level'" a research analyst stated. 

 As athletes minimize the use of NSAIDS, opioids, and prescription sleeping aids, their performance and the length of time they can continue with it is dramatically increased. But what has many fascinated is the ability to use CBD on the field, in the opera house, at the Olympics, and onward. The ability to stop inflammation quickly and allow a sports player, guitarist, ballerina, vocalist, or other performer to continue instead of throw in the towel due to an injury that effects their ability is front and center - it's no longer a fantasy to believe we can fix some problems, even if temporarily, literally at the drop of a dime thanks to cannabinoid medicine. 

When we stop and consider many of our everyday lives, many of us live like athletes!

 Thank you for visiting GCRC, 

-Mike Robinson, Founder - Global Cannabinoid Research Center  / GCRC Publications 

Read The (HUG) Hemp Users Guide 

Contact Mike today about opportunities with GCRC 

REFERENCES:  

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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.