September 20, 2023 by Fuel & Fortify

Race to Recovery: CBD's Role in Endurance Sports

As athletes seek ways to optimise their performance and well-being, the conversation surrounding CBD’s potential benefits becomes increasingly relevant and important. Can CBD find a legitimate place in sports recovery? This inquiry mirrors the broader societal shift towards cannabis acceptance and a nuanced understanding of the distinctions between CBD and THC.

While THC remains associated with psychoactive effects, CBD, or cannabidiol, has emerged as a nonpsychoactive compound with documented medical and therapeutic potential. Research indicates that CBD, derived from the marijuana plant, holds promise not only for addressing various health conditions but also for benefitting athletes seeking specific performance gains.

Since WADA removed CBD from the Prohibited List in 2018, it’s cleared the path for further research into its effects on endurance training and recovery routines—in addition to its more commonplace adoption as a potential therapeutic substance in the management of some common sleep and anxiety disorders.

What is CBD

CBD is a phytocannabinoid—one of the many compounds found in the cannabis plant. Unlike its cousin THC (tetrahydrocannabinol), CBD does not produce the “high” associated with cannabis use.

Our bodies in fact produce endocannabinoids, and the system responsible for this is called the Endocannabinoid System (ECS). The prefix “endo-” in “endocannabinoid” literally meaning within or inside. ECS is a complex cell-signaling system that plays a crucial role in maintaining homeostasis, which refers to the body’s ability to maintain a stable internal environment.

CBD, when ingested, interacts with the body’s ECS, most importantly a pair of key receptors, CB¹ and CB². CB¹ receptors are primarily found in the brain and central nervous system. They play a key role in regulating various physiological functions, including mood, memory, appetite, pain sensation, and sleep. CB² receptors, on the other hand, are mainly found in the immune system, peripheral organs, and tissues associated with immune responses.

As an example, in epilepsy, there is often an imbalance between excitatory and inhibitory neurotransmitters in the brain. Excitatory neurotransmitters like glutamate can lead to excessive neuronal activity, potentially triggering seizures. While CBD does not directly bind to CB¹ receptors as THC does, it can still modulate the activity of these receptors.

Unlocking CBD’s Advantages for Athletes

So from managing inflammation and providing pain relief to addressing anxiety and depression, CBD could serve as a valuable, legal substance for athletes in addressing various challenges.

Pain Relief and Anti-Inflammation

When athletes engage in strenuous physical activities, they often experience microtrauma to their muscles and connective tissues. This microtrauma is a natural part of training and occurs when muscles are pushed to their limits, resulting in small tears and damage—which for the most part, is normal and necessary.

Recovery from exercise enables cells called fibroblasts to repair these tears and strengthen your muscles over time.

Research has unveiled that cannabinoid receptor signaling plays a role in controlling the growth and function of fibroblasts, which are pivotal cells involved in scar formation. While not specific to endurance training, understanding how cannabinoid signaling influences tissue repair and inflammation could potentially be relevant to athletes who experience injuries related to overuse such as joint pain and even arthritis.

Acute pain however, can be an unintended consequence of high intensity, which is usually successfully managed with non-steroidal anti-inflammatory drugs (NSAIDs), yet dependence on these can have some serious health implications. NSAIDs typically function by inhibiting enzymes known as cyclooxygenases (COX), which can lead to side effects such as digestive problems and headaches when used for prolonged pain management.

Improved Sleep

Research on the use of CBD as an anti-anxiety and sleep aid primarily relies on animal and pre-clinical studies, with limited human data available and sufficient scientific evidence is lacking.

It’s essential to note however, that individuals who already experience restful sleep shouldn’t reach for CBD to further enhance their sleep quality and should only really be contemplated if there are some serious underlying sleep issues at play.

Should further studies be carried out in future it will be interesting to observe if CBD can yield similar results to those reported by THC with respect to sleep quality, such as reduced sleep onset latency (time it takes to fall asleep), increased total sleep time, and decreased wake after sleep onset (time spent awake during the sleep period).

Concussion and Brain Injury

Let’s face it, discussions about head injuries or concussions rarely involve endurance sports. However, the truth remains that accidents, like in cycling, can lead to devastating outcomes on the brain. If we broaden the scope a little—Traumatic Brain Injury (TBI) is a global health crisis, affecting millions annually, yet it often goes underdiagnosed and underreported due to varying symptoms and severity. Even mild TBIs can lead to long-term mental health issues like depression and cognitive changes.

TBI is broken down into two waves of disturbances—the primary injury from the immediate impact, while the secondary injury involves ongoing cellular and biochemical changes that exacerbate brain damage following a traumatic event.

Among several consequences of TBI, the Blood-Brain Barrier (BBB) is one that can certainly be compromised. The BBB is a specialized system that controls the movement of substances between the bloodstream and the brain, protecting the brain from harmful toxins and infections.

Pre-clinical studies have demonstrated CBD’s ability to maintain the strength of the BBB by protecting important proteins (claudin-5 and occludin) that keep it “tight”. CBD also lowers the levels of TNF-α, a molecule that can cause inflammation and harm the BBB.

Stress and Anxiety Reduction

The demands of endurance training and competition can take a toll on an athlete’s mental well-being, formally defined as Sports Performance Anxiety (SPA). CBD has been found to have anxiolytic (anxiety-reducing) effects, which may help athletes manage pre-race jitters and overall stress levels.

In certain situations known to induce stress, CBD has demonstrated effectiveness similar to anxiolytic drugs that target 5-HT1A receptors (a specific serotonin receptor subtype that can have calming effects). These receptors play a role in reducing anxiety and are often targeted by medications used to alleviate performance anxiety, such as during public speaking. However, it’s worth noting that some studies have reported no significant effects of CBD.

Focus and Pain Threshold

An intriguing aspect emerges when discussing pain perception and perceived effort in the context of CBD use during aerobic exercise. Research has indicated that CBD can enhance “ratings of pleasure” without causing performance impairment. Although pain studies in the realm of endurance are limited, these findings provoke thought regarding the potential impact of cannabis and cannabinoids on various aspects of pain responsiveness.

Appropriate Dosage

The fast-paced societal adoption of CBD is most definitely in full swing, and research supports the idea that CBD users should not face restrictions on their civil rights, such as driving. A University of Sydney study confirmed that even at the highest medicinal dose of 1500mg, CBD does not cause driving impairment.

Determining the appropriate CBD dosage remains a topic of debate, contingent on its intended purpose. For instance, research has shown an inverted U-shaped dose-response relationship in addressing acute anxiety (e.g., public speaking), where a dosage of 300mg yielded better results than 150mg and 600mg.

CBD ain’t cheap however, and that’s why trials have been carried out with considerably smaller doses—and surprisingly, with the same level of effectiveness. In one study, anxiety and sleep scores improved in 78% and 56% of patients, respectively, with doses ranging from 25-75mg.

In need of getting a bit more specific on an appropriate dosage however, the only FDA-approved cannabis-derived product, Epidiolex (primarily used for treating seizures), prescribes a daily dosage of 5 mg/kg. In terms of guidelines, this is about as official as it gets in this day and age.

CBD Contamination Risks

Despite product labels claiming to contain pure CBD, there is a significant risk of contamination. The complexity arises from the presence of numerous cannabinoids beyond just CBD in these products. Research has uncovered instances of CBD products containing inaccurate levels of other cannabinoids. At least 58% of the global CBD product pool have been tested to show CBD dosages higher than advertised and with 35% of products containing THC (all within the legal limit of 0.3% mind you).

Considering that the threshold for WADA’s prohibited THC concentration level is set at 150ng/ML, it’s evident that using any ordinary CBD product, whether through inhalation (vaping), edibles, or topicals, professional athletes who are subject to frequent doping protocols are really skating on thin ice.

Experiment Mindfully

CBD is gaining serious attention as a potential natural supplement to aid endurance athletes, specifically in their recovery journey. While there are promising physiological and biochemical benefits of CBD, it’s crucial to acknowledge that research in this area is still in its early stages for endurance.

For recreational athletes not bound by doping regulations, self-experimentation might be acceptable. However, for athletes dependent on competition for their livelihood, the potential risks associated with THC contamination do not make it overly viable in absence of adequate regulation.

The world is changing fast however, so it’s most definitely a case of watch this space.