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How Cannabis Helps Athletes Get Back on Track After an Injury

Due to a combination of medical and technological advancements, athletes today are getting more and more competitive. By using composite tennis racquets to Regenokine, from LZR swimsuits to Tommy John Surgery, sportsmen and women all over the world have become better, faster, and stronger than ever before.

However, there is one thing that continue to plague athletes, no matter how many innovations there have been over the years: sports-related injuries. These range from minor cuts, sprains, and strains to more severe, even career-ending injuries like improperly healed fractures and torn muscles and ligaments. It may even be argued that these players’ quest for greatness has given rise to more frequent and worsening injuries.

Unfortunately, the increased occurrence of sports injuries has also driven the increased usage of painkillers, most of which can be dangerously addictive. Indeed, a growing number of athletes, both active and retired, who experience severe acute and chronic pain due to injuries also suffer from opioid addiction. In addition, painkillers like Vicodin are prescribed more freely in professional sports than any other kind of drug. This contributes to cases of addiction, misuse, and overdose.

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Cannabis as an Opioid Alternative

One alternative that both athletes and medical, even mental health professionals are looking into is the use of cannabis and its derivatives like cannabutter and cannabis oil for pain relief. With more than 12 million people turning to marijuana to deal with chronic pain relief, and with 28 states already adopting laws to make cannabis legal both medically and recreationally, more and more professional athletes are showing their support for the therapeutic potentials of the herb, especially in dealing with post-injury pain. Retired NFL offensive tackle Eugene Monroe, who himself suffered from multiple knee and shoulder injuries over the course of his career, even published an open letter that detailed how cannabis was “far more effective” than any other prescription drugs he was given throughout his career and that cannabis didn’t have “the side effects that only led me to being prescribed even more drugs.” He also said that he wanted to “get to a place where NFL team doctors can prescribe cannabis as a treatment.”

Indeed, studies have shown that certain components of the cannabis plant — such as tetrahydrocannabinol (THC) and cannabidiol (CBD) — have pain-killing properties that act similarly to common drugs like acetaminophen and aspirin. And because THC and CBD closely resemble the structure of the body’s own endocannabinoids (neurotransmitters that regulate various cognitive and physiological processes, including pain), they bind more effectively with the body’s cannabinoid receptors to induce analgesia.

An earlier study conducted in 1991 actually found that THC is two times more potent than hydrocortisone and 20 times more than aspirin. Meanwhile, CBD has been found to stop the body’s absorption of another endocannabinoid called anandamide, which can help reduce the feeling of pain. CBD also inhibits the production of proinflammatory proteins, making cannabis an effective treatment against inflammation.

CBD and cannabichromene (CBC), another non-psychoactive cannabinoid, on the other hand, have been proven to successfully target the RVM in rat models. Cannabinoid receptors located in the RVM or the rostral ventromedial medulla play a critical role in managing neuropathic pain. These findings confirm that marijuana may be an effective treatment for neuropathic pain caused by sports-related injuries, cancer, and diabetes, among other health concerns.

More recently, studies also began to look into the pain-relieving properties of other compounds found in cannabis. One paper, in particular, delved into the analgesic potentials of terpenes, the fragrant oils that give different strains of cannabis their own unique aromas, like limonene (lemon or citrus), myrcene (mango), and pinene (pine).

Why is Marijuana Banned in Competitive Sports?

The World Anti-Doping Agency (WADA) created the Prohibited List of substances across all sports and the International Standard for Therapeutic Use Exemptions. To be classified as prohibited, a substance must fulfill two out of three criteria: (1) it has the potential to enhance or enhances sport performance; (2) it represents an actual or potential health risk; and (3) it violates the spirit of sport.   

The Prohibited List is revised annually. Since WADA crafted the list in 2004, marijuana and cannabinoids have been prohibitedto be used in competitions. Among the “violations” of cannabis based on the criteria include its potential to increase focus and decrease feelings of anxiety and tension, which may result in better performance under pressure (criteria 1), as well as its reported health risks like respiratory problems and association with mental illnesses (criteria 2). Cannabis also violates the third criteria in that its use is in conflict with the image of a role model, and its illegality thus produces negative reactions from different sectors of society.

The US Anti-Doping Agency (USADA) is among the hundreds of signatories of the World Anti-Doping Code, also developed and maintained by WADA. All signatories — which include organizations like FIBA, FIFA, IFAF, ITF, World Rugby, and Olympic Committees worldwide — need to implement and comply with the Code.

Pro-Marijuana Sports Figures

There is no shortage of athletes and sports figures that have voiced their support for cannabis as a legal option in post-injury pain management, among them ultramarathoner Avery Collins; UFC commentator and jiu-jitsu black-belt Joe Rogan; retired NFL stars Jake Plummer who played as a quarterback and Ebenezer Ekuban who was a defensive end; and Jim McAlpine, a weightlifter and open-water swimmer who also founded the 420 Games, a series of sporting events that take place in California, Colorado, Washington, Oregon, Arizona, Maine, Florida, and Nevada that promotes the responsible use of cannabis. McAlpine also recently opened Power Plant Fitness in San Francisco, California, a gym-cum-wellness center that allows members to consume marijuana products, supervised by fitness professionals who are also knowledgeable about cannabis.

Even NBA-player-turned-coach Steve Kerr has said that he hopes that the league would soften its stance on the use of cannabis. Kerr, who underwent two back surgeries in 2015, experienced chronic back pains and has admitted to have used marijuana to help deal with the discomfort. And while he said that marijuana “doesn’t agree” with him, he also acknowledged that “... pot is better for your body than Vicodin. And yet, athletes everywhere are prescribed Vicodin like it’s Vitamin C, like it’s no big deal.”

Meanwhile, UFC fighter Nate Diaz, who was originally handed a 5-year ban by the Nevada Athletic Commission after testing positive for marijuana, is considered instrumental to the NAC’s plans to discuss the removal of cannabinoids in its Prohibited Substances list. Nevada’s legalization of cannabis also played a role in this move, although it is undeniable that Diaz had a huge impact, especially since the public outcry about his ban from the sport, which was subsequently reduced to 18 months. Diaz famously smoked CBD through a vape pen during a press conference in August 2016, which he uses to treat symptoms of concussions and chronic traumatic encephalopathy or CTE, a neurodegenerative disease commonly found in people who have suffered multiple head injuries.

Research And Studies Show That Cannabis May Be Able To Help With Sports Injuries

Cannabis Strains for Managing Pain

There are several, more healthful ways to consume marijuana, especially for athletes who always need to be in top shape. These include edibles, transdermal patches, and topical creams; even vaping cannabis oil is considered safer compared to smoking marijuana. Whichever way an athlete decides to use marijuana, however, there are certain strains that are more effective in dealing with chronic pain and fatigue.

  1. OG Kush. This is one of the most well-known cannabis strains, with THC concentrations ranging from 20 to 25%. OG Kush also has high amounts of pain-relieving terpenes like linalool (lavender) and myrcene, the latter of which also acts as a muscle relaxant. However, the high THC content may induce both psychoactivity and sleepiness — athletes who want a good night’s rest after an intense round of physical therapy might find this strain extremely helpful.

  2. Canna-Tsu. A sativa-dominant hybrid, Canna-Tsu is not only beneficial for pain management but also for dealing with muscle spasms. The high levels of CBD in Canna-Tsu also make it an effective treatment for inflammations. This strain is ideal for daytime consumption, since it has little to no psychoactive effects.

  3. Harlequin. Apart from its anti-inflammatory and analgesic properties, Harlequin can also be used to fight anxiety symptoms. Similar to Canna-Tsu, athletes can also use Harlequin during the day without worrying about experiencing any intoxication, as it has a CBD to THC ratio of 5:2.

  4. Sour Diesel. This strain is rather unique, in that it is THC-heavy and thus highly psychoactive, but is also associated with mood-boosting and energizing properties. Therefore, Sour Diesel may be consumed either during the day or at night, depending on how it affects the user. Apart from treating pain, Sour Diesel or “Sour D” may also be used to decrease symptoms of depression.

  5. Afghan Kush. Also called Afghan OG, this popular strain is often used for crossbreeding cannabis plants. It is rich in both THC and CBD (21% and 6%, respectively), which makes it effective in treating chronic pain and muscle spasms and cramps. If you need some quality shut-eye, Afghan Kush is also a popular sleep aid.

  6. White Widow. A “true” White Widow should be a 50-50 hybrid between a pure sativa and a pure indica. The resulting plant provides the best of both worlds: an uplifting buzz that eases away pain. White Widow is also rich in linalool, giving it a light, soothing aroma. Apart from being a powerful painkiller, White Widow also has anti-inflammatory properties that help address inflammations in the muscles and along the spine, preventing tissue scarring, which is crucial for athletes.

  7. Jack Herer. Jack Herer is a sativa-dominant hybrid named after the famous cannabis activist and author. But compared to other strains that rely on either or both THC and CBD to relieve pain, Jack Herer is also heavy with terpenes like pinene, myrcene, caryophyllene (pepper), which not only exhibit pain-killing properties, but also neuroprotective and anti-inflammatory capabilities.
  8. Superbud. Like Jack Herer, Superbud is filled to the brim with terpenes, chief of which are caryophyllene, pinene, and myrcene. This hybrid also has high THC levels (up to 18%), resulting in a strong high that is not too overwhelming. Adding to Superbud’s pain-killing capabilities is the lesser-known cannabinoid cannabinol (CBN), which helps trigger the release of endorphins and relax blood vessels.
  9. Cannatonic. Cannatonic is a popular strain for medical marijuana, as it is a high-CBD strain with THC levels that rarely go beyond 6%. This strain has a smooth, mellow effect that is also influenced by its linalool content. Cannatonic is popular among sufferers of chronic pain, especially those caused by inflammations, arthritis, and surgeries.

  10. Cataract Kush. Those suffering from pain associated with spinal injuries and other back pains may find comfort with Cataract Kush. This is a crossbreed between two highly potent strains LA Confidential and OG Kush, so new cannabis users should exercise caution in using this strain. Cataract Kush is also famous for being a “creeper,” with a high that keeps on building even hours after consumption. Apart from pain management, Cataract Kush is also a powerful sleep aid.

Overall, it looks like the move to legalize cannabis in the States is on the right track. Sativex, an oromucosal spray with a 1:1 THC to CBD ratio, is already approved in Canada for treating neuropathic pain caused by multiple sclerosis and cancer, and has since been granted by the US FDA a Fast Track Designation. This expedites the medication’s development and review as an alternative treatment for patients who don’t respond well to opioid therapy.

Whether this progress reflects onto the field of sports remains to be seen. Nonetheless, with more and more voices joining the call to remove the herb in the list of banned substances in sports, it may happen sooner than we realize.