The use of cannabidiol (CBD) among athletes is becoming extensive and frequent. This could be due to the elimination of CBD from the list of prohibited substances by federations and international institutions of sport. The legalization and resulting production, and commercialization of CBD, could increase its intake in sports professionals.
This commercialization of cannabinoids has fueled a race to study their properties, benefits, and risks for health and performance in athletes. Although there is evidence that suggests some beneficial properties such as anxiolytics, antidepressants, anti-inflammatory, and antioxidants among others, the evidence presented so far is neither clear nor conclusive.
There are significant gaps in knowledge of the physiological pathways that explain the role of CBD in sports performance. This mini-review examines evidence suggesting that CBD has the potential to be used as a part of the strategies to recover from fatigue and muscle damage related to physical and cognitive exertion in sports.
With the exclusion of CBD from the prohibited substances in 2018, and even before, the use of CBD among athletes has considerably increased and is still accelerating. Cannabinoids are considered the second most commonly used substance among contact sports athletes replacing nicotine.
Evidence has shown that a third of cyclists, triathletes, and runners are or have been cannabinoids users (mostly ≥ 40 years of age, male, THC + CBD consumers ≤3 times weekly, and exercise 5–7 days per week).
Also, a quarter of university athletes report using cannabis-related products.
Especially in contact sports like rugby, the use rate of CBD is 28%, increasing with age, and reporting pain relief and sleep quality improvements as perceived benefits. Athletes require more information and advice, as product labels can be misleading about whether they contain THC, meaning there are risks in terms of violating anti-doping rules.
Inflammation and oxidative stress underlie many human chronic and acute health conditions and pathologies. In this sense, and considering that exercise-related damage and fatigue mediate inflammation, proliferation, and oxidative stress in most cases, it is hypothesized that CBD-related inhibitions in oxidative stress and neuroinflammation could have some therapeutic potential in sports research.
This statement is based on evidence suggesting that CBD could induce changes in cortisol release, regulating inflammatory response to injury. This mediation is due to the interaction between CBD CB1, and CB2 cannabinoids and adenosine receptors, leading to reduced cytokine levels and downregulating overreactive immune cells.
Also, CBD intake seems to mediate processes associated with gastrointestinal damage protection, due to inflammation, and promote healing of skeletal injuries.
Cannabidiol has been commonly used for its analgesic properties in a variety of pain disorders.
CBD consumption could exhibit a beneficial effect over edema and hyperalgesia, acting directly on the central nervous system and leading to sedative effects.
The idea of considering CBD as an antinociceptive agent is based on the efficiency of treating the pain associated with proinflammatory cytokine release due to the activation of Vanilloid receptors, provoking antinociceptive effects and reducing the perception of pain. CBD could inhibit presynaptic neurotransmitters and neuropeptide release, modulate postsynaptic neuronal excitability, activate the descending inhibitory pain pathway, and reduce neuroinflammatory signaling.
Overreaching and overtraining are often presented in athletes due to high training loads accompanied by subsequent insufficient recovery between efforts. These abovementioned states are usually accompanied by sleep disorders and higher sleep disturbance, leading to poor sleep quality.
CBD consumption could stimulate the endocannabinoid system modulating sleep disorders and the sleep–wake cycle.
Promising, but no specific, evidence suggests using cannabinoids like CBD to reduce sleep disorders in athletes or even in healthy or pathologic humans. Endocannabinoid system receptors as anandamide and type-1 are associated with sleep-promoting effects, but the physiological mechanism is not fully understood and is based mainly on preclinical studies.
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