Athletes go through tremendous amounts of stress during physical training that can put a lot of strain on both body and mind. A potential therapeutic agent may be CBD, the non-psychoactive cannabidiol found in cannabis. According to a recent review of the scientific literature published thus far, CBD “may exert a number of physiological, biochemical, and psychological effects with the potential to benefit athletes.”

Limited but promising evidence of CBD boosting athletic performance

Cannabidiol (CBD) is one of the many compounds found in Cannabaceae plants. It can be extracted from both the marijuana and hemp plants; however, most US states require that CBD oil products come from hemp and do not contain more than 0.03% THC. CBD oil does not produce a high, but it does interact with brain chemistry, so saying it is completely non-psychoactive would be inaccurate. 

CBD products, whether oil, eatables, or topicals, have soared in popularity in recent years, as many consumers have become enchanted by its therapeutic properties.

While there is a lot of marketing and hype surrounding CBD products, there is scientific evidence supporting cannabidiol therapeutic value, particularly for relieving pain and anxiety.

In 2019, researchers at McGill University Health Centre (MUHC) and McGill University, Canada found that CBD binds to specific receptors involved in anxiety (serotonin 5-HT1A) and pain (vanilloid TRPV1).

Rat experiments administered with 5 mg/kg/day of CBD as an intravenous dose showed this dose increased 5-HT firing through desensitization of 5-HT1A receptors. Treatment with CBD for seven days reduced mechanical allodynia (when pain is experienced despite there being no obvious cause for pain), normalized 5-HT activity, and decreased behavior which was anxiety-like.

In a new study published in Sports Medicine, researchers led by Danielle McCartney of the University of Sydney reviewed more than 200 previously published studies on the physiological, biochemical, and psychological effects of CBD that may be relevant to sport and/or exercise performance.

McCartney and colleagues were inspired to go on this route after they noticed an increasing number of high-profile professional atheletes overtly sharing their CBD use.

Around 15 years ago, cannabis use was prohibited from all sports during competitions by the World Anti-Doping Agency. However, in 2018, CBD was removed from the prohibited list following mounting scientific evidence that CBD is safe, well-tolerated by humans, and it doesn’t produce psychoactive effects.

Unfortunately, the benefits of CBD for athletes’ health and performance are challenging to determine because there no studies that have focused on athletes and CBD specifically, although there are some positive results reported for THC and CBD in combination. So, the researchers investigated CBD in the context of sports performance drawing primarily from preclinical studies involving laboratory animals and a limited number of clinical trials involving non-athlete populations.

According to the findings, CBD seems to play an active role in modulating inflammatory processes, attenuating immune cell accumulation and stimulating the production of anti-inflammatory cytokines.

This effect may be important in the context of athletic performance since strenuous exercise is known to cause ultrastructural damage to skeletal muscles and the surrounding extracellular matrix. Consequently, this leads to inflammation, and excessive inflammation may contribute to prolonged muscle soreness and delayed functional recovery.

CBD also seems to have neuroprotective effects, perhaps aiding in concussion and subconcussive recovery. However, the precise mechanisms that underpin these neuroprotective effects are not completely understood.

CBD also seems to have neuroprotective effects, perhaps aiding in concussion and subconcussive recovery. However, the precise mechanisms that underpin these neuroprotective effects aren’t understood completely.

Preclinical studies have shown beneficial CBD effects in neurodegeneration animal models (e.g. the Alzheimer’s disease transgenic model and brain iron-overload), the authors stated in their review. This data, when taken collectively, would then suggest that it may be necessary to investigate the use of CBD in the long-term effects of harmful repeated sports concussions.

Although there are only a few studies that have investigated the therapeutic effect of CBD administered alone for pain-relief,  most preclinical studies appear to have observed a significant analgesic effect, the authors concluded.

The researchers emphasized that it’s important to recognise that the analgesic effects of CBD depend on several factors, including the pain type involved and the treatment dose. Indeed, low doses of CBD (e.g. ≤ 1 mg·kg⁻¹, i.p.) do not consistently attenuate pain; while higher doses are found occasionally to be more, and other times, less, efficacious than moderate doses in preclinical studies.

Strenuous exercise is known to pump blood in the muscle, cardiopulmonary system, and skin. Meanwhile, other tissues and organs experience oxygen and nutrient delivery deficiencies, including the gastrointestinal (GI) tract.

According to the researchers, impaired nutritional uptake and GI distress such as vomiting, nausea, abdominal angina, and bloody diarrhoea may negatively influence performance and post-recovery of those exercising.

Based on the review, there is evidence that CBD can manage some of the exercise-induced gastrointestinal damage. However, this evidence is limited and only involved animal studies.

The researchers then noted that there have been reports wherein other inflammatory-agents, such as the NSAID, ibuprofen exacerbated exercise-induced GI damage and impaired gut barrier function.

Many professional athletes experience pre-competition stress and sports performance anxiety, which can ultimately affect their athletic performance. This impairment can be the result of both direct (anxiety) and indirect (loss of sleep, increased energy expenditure) effects.

Overall, studies suggest that CBD has little influence on anxiety under “low stress” conditions. However, relatively high doses of CBD (300-600mg) was found to relieve anxiety in individuals under “stress-inducing” conditions (i.e. public speaking) in both healthy individuals and those suffering from social anxiety disorder.

At the same time, other studies have found no evidence of anxiety-relieving effects for CBD. As such, further research is warranted.

Better sleep was not supported by the evidence discovered by the researchers, although this property is marketed heavily by many CBD brands. The authors also added that: “Cognitive function and thermoregulation appear to be unaffected by CBD while effects on food intake, metabolic function, cardiovascular function, and infection require further study.”