For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover. As athletes age, this recovery time becomes even longer.
Because of this, athletes are discovering the advantages of cannabidiol (CBD). With its anti-inflammatory properties and studies showing it helps with pain relief, CBD is starting to be the medicine of choice for the professional athlete and weekend warrior alike.
CBD as Pain Relief for Athletes
Typically, after working out, ibuprofen or another type of nonsteroidal anti-inflammatory drug (NSAID) is taken to reduce the pain from the delayed onset of soreness. Many people do not realize there is an increased risk of gastrointestinal ulcers and bleeds, heart attack and kidney disease1 from repeatedly taking this medicine. In contrast, studies2 are showing that CBD can reduce pain, with doses of up to 1,500 mg/day reportedly well-tolerated. Daily doses of NSAIDs can have severe medical side effects, but CBD has no known negative health consequences.2
Inflammation can prevent athletes from performing. There is evidence that a topical CBD cream3 has anti-inflammatory properties and according to the authors, "Data indicate that topical CBD application has therapeutic potential for relief of arthritis pain-related behaviors and inflammation without evident side-effects."
While this study was focused on arthritis and joint pain, there is a correlation that CBD can be effective for post-exercise recovery and reduce the inflammation brought on by it.
In an article from Medical News Today,4 the author writes, "CBD stops the body from absorbing anandamide, one compound associated with regulating pain. Increased levels of anandamide in the bloodstream may reduce the amount of pain a person feels." The author continues by stating that CBD can limit inflammation in the brain and nervous system, helping people experiencing pain. Once the pain levels are decreased, recovery can begin.
"No pain, no gain" is an adage we've heard since middle-school P.E. While pain isn't something we can eliminate completely with CBD, it can be managed so it doesn't prevent the athlete from rejoining the action.
The Science of CBD
The human body has an endocannabinoid system (ECS) that helps regulate functions such as sleep, immune-system responses and pain. A study published in Neurotherapeutics states that CBD activates or inhibits other compounds in the endocannabinoid system5 which include pain. One way CBD does this is by stopping the body from absorbing anandamide,5 a compound associated with regulating pain.
Additionally, a study by the Laboratory for Integrative Neuroscience at the National Institutes of Health6 showed that CBD "has significant anti-inflammatory properties and the ability to suppress inflammatory responses by targeting certain receptors."
The Stigma of CBD
CBD has a stigma due to the fact that it is closely related to cannabis, which is still illegal on a federal level, although many states have legalized it for medical and personal use. Much of the debate and argument over the substance doesn't apply to CBD since it doesn't have the psychotropic effects of cannabis.
Further reducing the stigma of CBD, the World Anti-Doping Agency (WADA) removed it from its 2018 Prohibited List7 and allows its use for athletes in and out of competition.
As more and more states legalize cannabis, in addition to the WADA action, the associated stigma will disappear and the health benefits will be more widely recognized.
When to Prescribe CBD for Athletes
For the athlete, whether professional or amateur, pain and inflammation are often part of the sport / activity. CBD is a great alternative to NSAIDs, which are usually prescribed. Studies of acute and chronic pain have demonstrated the efficacy of cannabinoid receptor agonists, even in neuropathic or inflammatory pain.8
Using CBD, pain relief comes without the negative side effects of ibuprofen such as nausea, chest pain, shortness of breath, and a host of other symptoms. CBD has been shown to be safe on the stomach.
If pre-game nerves are an issue, CBD is also known for its anti-anxiety qualities, making it a better choice than Valium or Xanax, which have side effects including headaches, nausea and insomnia. In "Cannabidiol as a Potential Treatment for Anxiety Disorders" in Neurotherapeutics,9 the authors state, "Preclinical evidence conclusively demonstrates CBD's efficacy in reducing anxiety behaviors relevant to multiple disorders." It can be extrapolated that CBD can help with anxiety related to athletic performance and provide a sense of calm.
If the pain or soreness is localized, a transdermal CBD cream applied to the area is recommended. The transdermal cream is absorbed through the skin, penetrating muscle and tissue, and entering the bloodstream. Regular creams and lotions do not penetrate the skin, staying on the epidermis.
Additionally, transdermal cream also offers greater bioavailability10 in contrast to oral CBD, which must work its way through the kidneys, losing some potency along the way.
Editor's Note: A brief summary of MPA Media's recent survey on CBD / hemp oil use within chiropractic practices is available by clicking here.
References
Bally M, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ, 2017;357:j1909.
Bergamaschi MM, et al. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf, 2011 Sep 1;6(4):237-49.
Hammell DC, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. Eur J Pain, 2016 Jul; 20(6):936-948.
Johnson J. "Does CBD Oil Work for Chronic Pain Management?" Medical News Today, last updated March 16, 2018.
Rosenberg EC, et al. Cannabinoids and epilepsy. Neurotherapeutics, 2015 Oct;12(4):747-768.
Nagarkatti P, et al. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem, 2009 Oct;1(7):1333-1349.
Manzanares J, et al. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Curr Neuropharmacol, 2006 Jul;4(3):239-257.
Blessing ES, et al. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 2015 Oct;12(4):825-836.
Prausnitz MR, et al. Transdermal drug delivery. Nat Biotechnol, 2008 Nov;26(11):1261-1268.
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