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CBD for Sports – Introduction 

The growing interest in the promotion of the medicinal properties of Cannabis and Marijuana compounds, has led to a growing body of knowledge, research as well as awareness about Cannabis derivatives. 

Studies¹ state that since the 19th century, cannabis preparations were in widespread use in Western medicine for a very wide number of indications such as analgesia, sedation, convulsions, asthma, appetite stimulation and muscle relaxation.

As an extension to the article on CBD for athletic professionals, this compilation of analysis would like to focus on the applicability of CBD for various medical conditions such as Concussions, neurological complications, sports-related injuries, pain management cardiovascular diseases and musculoskeletal disorders experienced by sports professionals involved in high-risk sports.

CBD for MMA professionals

MMA professionals suffer from severe head and brain-related injuries which calls for proper diagnosis, management, and timely treatment. According to a study published for the British Journal of Sports Medicine,² “there has been no written consensus statements specifically for combat sports regarding the management of combatants who have suffered a concussion or for return to competition after a concussion”.

Therefore, this article would focus on reviewing literature and conclusions that deal with treatment for Concussions and the rate of return to play with special reference to the applicability of CBD as a potential cure. 

What is MMA?

Mixed martial arts(MMA), also called cage fighting, has established itself as a popular televised sport. The reason behind this name could be because the techniques used in this sport combines techniques that include striking, grappling, and ground fighting.

Also, it draws styles from other disciplines such as muay thai, Brazilian jiu-jitsu, boxing, kickboxing, and wrestling.

Further, the origin of the sport can be traced back to Ancient Greece, Ancient China, Ancient Egypt, India, and Japan. The fighters are unarmed and are free to attack the opponent using all moves except biting or gouging used to be allowed in the olden days, after which the sport became modern and sophisticated for television.

A sport that relates much to symptoms of concussions is Mixed Martial Arts. 

Medical conditions in combat sports 

Combat sports like Boxing, Wrestling, Fencing, MMA, etc come with tackling extreme challenges. This puts them into high risk of succumbing to severe injuries, pain and difficulty to return to play and also dealing with daily life. 

A 2019 study³ on the dangers of Mixed Martial Arts focussed on Chronic traumatic encephalopathy (CTE) which was first discovered in professional boxers after they exhibited memory impairments, mood and behavioral changes after years of boxing. This study alerts the public to be aware of the dangers of this attractive sport as CTE could turn out to be a ‘chronic and debilitating illness with incapacitating neuropsychiatric sequelae’.

“Canadian researchers writing in the American Journal of Sports Medicine in 2014 found that an MMA fighter suffered a traumatic brain injury in almost one-third of professional bouts”.The reason for this is that the fighting technique in the sport involves direct punches and hard blows to the head, face, or any body part that triggers concussions by way of a sudden force transmitted to the head. 

On one hand, a 2018  study⁴ states that concussions are short-lived impairment of neurological function that resolves spontaneously.

On the other hand, a review study,⁵ reports, Concussion as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. Concussion is also a subset of mild traumatic brain injury (MTBI) which is generally self-limited and at the less-severe end of the brain injury spectrum.

Further, repetitive head trauma, persistent headaches, cognitive difficulties, impairments in learning and memory, information processing speed, frontal executive functions such as planning, organization, reasoning, and judgment, mood changes including symptoms of depression, apathy, irritability, and suicidal thinking, Dementia in all older cases, are some of the other conditions faced by MMA professionals.

CBD for Concussions

A 2019 clinical trial report asserts  that there is currently no pharmaceutical treatment for concussions, “When you get to the emergency room with a concussion, they basically tell you to go home and rest, and maybe give you some ibuprofen”.

Having discussed the severity of concussions and the traumatic pain that professionals undergo, the above statement seems to sideline the condition. Evaluation, diagnosis, and management of sports injuries especially concussions is very important.

A study on concussion in sport⁵ highlights that the incidence of injuries in certain sports, or positions and individual playing styles could have a greater risk of concussion.

It also reports that youth athletes may have a more prolonged recovery and are more susceptible to a concussion accompanied by a catastrophic injury.   

The 2019 clinical trial is a 5 year study conducting research on a pill that combines CBD and Dexanabiol, which researchers believe will reduce brain inflammation.

Some of the areas that these trails are exploring are:

• Cannabinoid-based methods of „reducing post-concussion brain cell inflammation, which causes headaches and other neurological complications.” 
• CBD activates receptors that trigger a cellular repair mechanism in the brain
• According to Dr. Hoffer, “What that pill would do is stabilize the brain, so that when you get a head injury, there may only be a few brain cells that are injured to the point of no return.”

Another report sums up the mechanisms of Cannabidiol as:

• CBD is an antagonist of CB1 and CB2 receptor agonists, thereby inhibiting inflammation.
• CBD inhibits reuptake of adenosine which enhances signaling and leads to anti-inflammation effects.
• CBD activates serotonin receptors which thereby increases cerebral blood flow.
• CBD is an NMDA-receptor antagonistic and scavenges for harmful free-radicals, thereby producing anti-oxidant effects.

To sum up, the use of cannabinoids such as CBD after a traumatic brain injury is linked to decreased inflammatory cell activation, improvements in mood, and reduced concussion symptoms.  

CBD for NBA players

The National Basketball Association (NBA) is an American men’s professional basketball league. And it is considered as the premier and the most popular basketball league in the world. 

Similar to other sports, NBA players are also prone to some medical conditions. 

According to a report published for an academic medical center focused on musculoskeletal health, it states that ‘Basketball players have one of the highest injury rates out of all the contact sports’. Apart from lower-body injuries in the knee, ankle, and foot, some of the most common injuries for both men and women are:

• Anterior Cruciate Ligament (ACL) tears of the knee
• Medial Collateral ligament (MCL) tears of the knee
• Ankle sprains
• Jumper’s knee
• Achilles tendon injuries
• Concussion

The common symptoms for all of these above injuries is chronic pain, and Inflammation that causes discomfort and an interruption in daily routine.

A 2015 research study⁶ explored that the administration of CBD helps heal bone fractures. 

According to Dr. Yankel Gabet, who jointly led the research quotes that “our bodies are equipped with a cannabinoid system, which regulates both vital and non-vital systems. We only respond to cannabis because we are built with intrinsic compounds and receptors that can also be activated by compounds in the cannabis plant,”

Some of the key findings of the research are: 

• The skeleton is regulated by cannabinoids. The addition of a non-psychogenic compound acting outside of the brain could affect the skeleton.
• CBD alone makes bones stronger during healing, enhancing the maturation of the collagenous matrix, which provides the basis for new mineralization of bone tissue,” said Dr. Gabet. „After being treated with CBD, the healed bone will be harder to break in the future.”
• A rodent model was studied in which one set was injected with CBD alone and another with a combination of CBD and THC. The results showed that CBD alone provided necessary therapeutic stimulus. 
• „We found CBD alone to be sufficiently effective in enhancing fracture healing,” said Dr. Gabet. „Other studies have also shown CBD to be a safe agent, which leads us to believe we should continue this line of study in clinical trials to assess its usefulness in improving human fracture healing.”

As a conclusive discussion for the above, this report has referenced several studies that highlight the benefits of CBD for pain management, Inflammation, and Concussions. 

Moreover, this website is exclusively dedicated to sharing research-based compilations of knowledge on the applicability of CBD to various medical conditions. 

CBD for Golfers

According to studies⁷ Golf game is a moderate-intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. 

Based on a survey that this study conducted on golf’s association with health and mechanisms, it mentions that the annual incidence of injury while playing golf is moderate and the risk of injury is also low as compared with other sports. It also points out that excessive exposure to the sun could cause skin cancer or skin related conditions.

Although several studies acknowledge the health benefits and problems faced by golfers, the magnitude would depend on the age, gender, fitness, overall health condition, lifestyle etc. 

According to a review reference⁸ some common injuries sustained by Golfers are:

• Low back injuries that occur because of the swing mechanics of the game. There are a number of swing variations that often result in poor swing practice, overuse or over practice.
• Wrist and Hand Injuries
• Elbow injuries
• Shoulder injuries
• Knee injuries
• Uncommon injuries include getting hit by a golf ball or club on the head or eye.
• Environmental issues such as lightning strikes, sunburn and skin cancer 

This article has cited the functional value of CBD in treating several health conditions including Pain, Inflammation, Immunity. 

With regard to skin-related conditions, the role of CBD in dermatology has been gaining significance. Studies say⁹ that pre-clinical studies are showing promising grounds for therapeutic application of cannabinoids for several skin diseases. This also opens up the scope for further research and controlled trials to corroborate the safety and efficacy of cannabinoids for medical skin conditions. 

CBD for Boxers

Boxing could also be categorised under combat sports based on the commonalities of the nature of injuries sustained by professional boxers. Studies¹⁰ assert that the major injuries were on the head, and lacerations, bruises to the face, followed by hands and fingers. It adds that severe injuries, such as concussions and fractures, are reported less frequently.

Contrary to this study, another study conducted a year later ¹¹ that focussed on Boxing related head injuries mentions that the rate of boxing-related head injuries, particularly concussions, remains unknown, due to its variability in clinical presentation. And the prevalence of repeated concussions sustained when boxing and the related neuronal injuries in proportions to the number of blows that a player receives repeatedly.

The applicability of CBD in concussions management has already been discussed above in detail under the heading CBD for MMA professionals. 

CBD for Football players

According to research some of the common injuries in football players include traumatic knee injuries that include ACL/ PCL, injuries to the acromioclavicular joint (ACJ), concussions, overuse injuries such as low-back pain, or back pain, patellar tendinitis (knee pain), heat injuries including heat stroke and exhaustion due to exposure to high temperatures result in excessive sweating that depletes salt and water in the body.

The National Football League Players Association (NFLPA) is researching the use of medical marijuana to help players manage pain, rather than prescription opioids.

Conclusion

Research on medical application of Cannabis, Marijuana, and hemp based products that are currently made available in various forms that include crystals, gummies, vapes, oils, creams, etc are plentily available and individuals who have experiential understanding of the various health benefits continue to use them.

According to a 2018 study¹² Cannabis use is more prevalent among professionals involved in sports including high-risk sports and most of them are self -reported use of Cannabis for pain and concussion management. The study concludes with a recommendation for further research on more specific and focussed research questions on the applicability of cannabinoids for injuries, pain medication, and other medical conditions. 

Therefore, the astounding interest and significance around medical cannabis, is capturing attention from professionals from various walks of life that includes academia, and Insurance. This would certainly make CBD more accessible for people who are desperately seeking relief from chronic medical conditions. 

References

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6. American Friends of Tel Aviv University. „No bones about it: Cannabis may be used to treat fractures: Tel Aviv University researcher finds non-psychotropic compound in marijuana can help heal bone fissures.” ScienceDaily. ScienceDaily, 16 July 2015 [↩]
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9. Eagleston, L. R, Kalani, N. K, Patel, R. R, Flaten, H. K, Dunnick, C. A, & Dellavalle, R. P. (2018). Cannabinoids in dermatology: a scoping review. Dermatology Online Journal, 24(6) Retrieved from  https://escholarship.org/uc/item/7pn8c0sb [↩]
10. Zazryn, Tsharni & McCrory, Paul & Cameron, Peter. (2009). Injury Rates and Risk Factors in Competitive Professional Boxing. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 19. 20-5. 10.1097/JSM.0b013e31818f1582 [↩]
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