Matthew Nguyen, BS
SUMMARY POINTS
Medical cannabis has the potential for benefit in alleviating muscle soreness, improving mental state, and enhancing recovery.
Medical cannabis has the potential for benefit in use following orthopaedic surgery in athletes
Medical cannabis may be useful acutely following sports injury.
However, much more research is needed to better understand the indications, dosages, and outcomes of medical cannabis.
ANALYSIS
Background
Cannabis has a long history of recreational and medical use worldwide. The two primary compounds in cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD), also known as phytocannabinoids. In the sports world, cannabis has been banned by the World Anti-Doping Agency (WADA) in all athletic competitions since 2004. However, in 2018, the WADA removed CBD from the prohibited list while all other natural and synthetic phytocannabinoids remain banned in all competitions [1]. Subsequently, medical cannabis for orthopaedic and sports injuries has gained interest. This research analysis aims to explore the possible uses of medical cannabis for sports injuries.
Findings
An athlete’s recovery plan is essential in maintaining a strong mental state, ensuring muscle recovery, and decreasing soreness. Since WADA lifted its ban on CBD, it has been sought for its possible anti-inflammatory, analgesic, anxiolytic, and neuroprotective effects [2]. In preclinical studies, CBD has been found to reduce pro-inflammatory cytokines, decrease immune cell buildup, and increase anti-inflammatory cytokines [2]. This has led to CBD becoming one of the most popular sports supplements on the market. For example, in contact sports, CBD has become the second most used substance after NSAIDs [3]. One study found that over 25% of professional rugby players in Europe have stated that they currently use or have used CBD [4]. Many of these athletes indicated using CBD for recovery, pain, or sleep, with 68% of them reporting perceived benefits [4]. No athletes reported any associated adverse effects [4]. Additionally, a six-arm placebo-controlled crossover study found significant changes in pro-regenerative effects 72 hours following administration of a single 60mg CBD supplement [5].
CBD may also provide qualities that could benefit mood. A systematic review revealed that CBD was useful in promoting sleep due to the endocannabinoid system’s effects on the sleep-wake cycle [3]. The same review found that CBD use may have anxiolytic effects in stress-inducing situations which can potentially help alleviate sports performance anxiety [3].
Athletes face a unique circumstance in that depending on the sport, they are more susceptible to certain injuries requiring surgical intervention. For example, arthroscopic shoulder labral repair, arthroscopic knee meniscectomy, and arthroscopic anterior crucial ligament reconstruction were among the most common procedures performed on college football players [6]. Between 2004 and 2014, the collegiate sport with the highest surgical incident rates were women’s gymnastics, men’s football, and men’s wrestling [7]. Like the public, athletes often receive postoperative opioid prescriptions, leaving them susceptible to misuse and addiction. Athletes may potentially benefit from postoperative medical cannabis use to decrease opioid use following surgery. One systematic review looked at 33 studies on medical cannabis use following orthopedic surgeries. The associated studies included randomized control trials, case reports, and survey studies [8]. Patients reported using medical cannabis to treat their post-trauma pain, post-operative pain, back pain, and arthritis. While many discrepancies were seen with medical cannabis products relative to their type, doses, and administration routes, preliminary evidence found advantages in its use for managing arthritis pain, post-operative pain, post-trauma pain, and back pain [8]. Since these issues are also common among athletes and sports injuries, medical cannabis also has the potential to be useful for athletes. However, there is a lack of research to date on medical cannabis for athletes following orthopedic surgery.
Discussion
Current evidence supports the potential benefits of medical cannabis use for the treatment of sports-related injuries in both traumatic and operative settings. However, the lack of data and high-quality studies makes it difficult to draw conclusions. Future research should focus on the efficacy of medical cannabis for sports injuries.
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