Elite athletes are extremely picky about what goes into their bodies, but some are eager to embrace the promise of cannabidiol, or CBD as it is better known.
CBD is one of the hundreds of cannabinoids, chemicals present in cannabis. It works within the body’s endocannabinoid system, a network of receptors and neurotransmitters that can influence pain perception, memory, and stress, amongst other things. Unlike the cannabinoid THC, CBD doesn’t impart marijuana’s characteristic high.
Marijuana is a schedule one drug in the United States, but in the world of sports, a special exception is made for CBD. In 2018, the World Anti-Doping Agency removed CBD from its banned substances list, though all other cannabinoids are still prohibited. CBD is still banned by US sports leagues and organizations because — as a marijuana-derived product — it is illegal in the US. But despite the domestic ban, athletes in the States are speaking out in favor of CBD. Rob Gronkowski, former New England Patriots tight end, Riley Cote, a former Philadelphia Flyers enforcer, and Paul Pierce retired NBA star are all CBD supporters. Pierce even owns a CBD company.
"The potential of marijuana for pain management has driven an athlete-driven movement toward acceptance."
University of California, Los Angeles professor and clinician Stuart Silverman, Ph.D., argues athletes like Pierce and Gronkowski are leading to more general acceptance of using marijuana products (particularly for pain management) in sports, even if scientists don’t know how CBD affects athletes.
“The problem we have with cannabis is that elite athletes still influence towards culture, beliefs, and opinions. The potential of marijuana for pain management has driven an athlete-driven movement toward acceptance,” Silverman tells Inverse.
They have inspired amateur athletes too, explains Scott Douglas, a journalist who has written several books on running and covers the sport for Runner’s World. He wrote a deep-dive into CBD for athletes — and conducted his own athletic CBD experiment. As a runner who has clocked over 110,000 miles, Douglas was skeptical of the “magic bullet” health claims being made around CBD:
“My initial experiment was: Take CBD daily for a month, change nothing else in my routine, and see what, if anything, I noticed. I would have been fine if the answer was I started to feel my training suffer; I would have written about that in the same way I wound up writing about the positive effects I felt,” he says.
The anecdotal stories of CBD’s magical qualities are numerous. What little science there is into the effects of CBD hints that it does hold some promise for athletes looking to enhance their performance and recovery. But what, exactly, it does for athletes remains an open question.
CBD and physical recovery
The promise of CBD for athletes comes largely for its effects off the track, field, court or water. Athletes like Gronkowski or other pros endorse CBD because they say it can help soothe aching muscles. It’s sold in gels or topical creams and easy to buy online and in stores, making it accessible to most.
From Silverman’s perspective, marketing ofCBD as a therapy is outpacing the science. The only Food and Drug Administration (FDA) approved form of CBD is Epidiolex, which is used to treat severe forms of epilepsy. Sellers who claim that CBD has other therapeutic effects receive warning letters from the FDA. Only seven such letters have been issued in 2019 so far, but some state health departments have started to crack down on CBD vendors as well.
The question of whether a CBD rub can help a distance runner soothe an aching hamstring, or a cyclist quell a screaming quad is untested, says Silverman.
“We don’t know the timing, dosages strains, the administration, and there’s no user manual around. Unfortunately, as long as cannabis remains schedule one, with all the accompanying limitations, the debate on cannabis’ impacts on athletic performance will continue without consensus,” says Silverman.
CBD and inflammation
There is some evidence suggesting the athletes’ claims may have a basis. Early studies suggest that CBD reduces inflammation in rat models of arthritis. Other animal studies suggest that the specific type of pain you’re dealing with (arthritic pain, chronic pain, acute pain) makes a difference as to how CBD works and how effective it is compared to traditional pain management drugs. In a 2018 review, published in Neuropsychopharmacology, scientists concluded that there is powerful evidence that cannabinoids can reduce inflammation, at least in rodent models.
But using that research to explain how CBD might affect human athletes isn’t a perfect comparison, Silverman says.
“Usually CBD alone itself is helpful topically, for example, as a rub on sore muscles. But how helpful it is for pain? We just don’t have data yet,” says Silverman.
CBD and athlete anxiety
Physical effects aside, there’s another reason athletes embrace CBD. CBD has a reputation as a salve for anxiety. Performance anxiety among athletes can range from pre-performance jitters to full-blown race anxiety — which can negatively affect performance.
“Some athletes I talked with value CBD’s calming effect before training and competition. This seems to be one of those highly individual things,” says Douglas.
There is some evidence that CBD does have anti-anxiety effects, but this is drawn from mouse studies. The results suggest that CBD can counteract THC’s links to increased anxiety. But experts still advise caution on jumping to conclusions about CBD’s impact on clinical anxiety — especially for people who struggle with anxiety or mental health conditions like depression. In a 2019 Mayo Clinic review, scientists warned that although CBD has been theorized as a way to treat conditions like anxiety and depression, there’s still little guidance surrounding how it should be used (or if it should be used at all) to treat these conditions.
“An athlete-driven movement toward acceptance”
Despite the anecdotes about how well CBD works for athletes, there has never been a clinical trial. But anecdotes can be powerful things, especially in sports.
Esoteric objects like a a golden thong or lucky urinal have been relied upon as performance enhancers in the past. Over the course of his journalistic career Douglas has seen runners reach for bee pollen and turn to cryogenic gas therapy to aid recovery. Cyclists have used brain stimulation devices to give them a competitive edge. Within that landscape, Douglas says he can see CBD sticking around.
“I think CBD could be one of those things that holds up over time,” he says.