Is CBD (cannabidiol) for runners and other athletes a fad supplement, or does it indeed live up to the promise that it will help you to perform better and recover faster? We take a look at the latest research and also at the doping situation. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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What is CBD?
Cannabidiol (CBD) is extracted from the cannabis plant. It should not be confused with the much more famous tetrahydrocannabinol (THC or delta-9-THC), which is the stuff that makes you high and which can be present in CBD extractions.
CBD is legal in some countries, illegal in others, and in some countries it must contain less than a certain amount of THC to be legal. In some countries where it is legal, it can only be obtained with a medical prescription.
Some athletes use it due to its apparent physiological and psychological effects. It can be taken in several ways, such as drinks, capsules, mouth sprays, and vaping.
How does CBD work in the body?
A 2023 review of research on how CBD could improve performance and recovery in sports found the following effects that could potentially enhance performance and/or help recovery:
Anti-inflammatory: Inflammation is a part of the natural repair-and-recovery process that kicks in as a response to the micro-damage caused by exercise. However, too much inflammation can cause damage to muscles, bones, and organs, and CBD could be useful to regulate inflammation after exercise.
Pain relief: CBD interferes with the information about pain sent to the brain, and it is already being used (in non-sports settings) for the management of acute and chronic pain. Also, it “appears to have a possible effect on reducing swelling and avoiding soreness after hard activity”.
Muscle repair and growth: CBD has the potential to increase the release of arachidonic acid in the body, which helps with the repair and growth of muscles.
Sleep quality: It is well-established that sleep plays an important role in post-workout recovery and injury prevention. CBD can help people to fall asleep quicker and to sleep with fewer interruptions.
💡What does this mean for runners?
It’s tempting to read the list of potential positive effects and immediately assume that CBD must be beneficial for recovery. However, suppressing inflammation after a training session may eventually turn out to be a bad idea for runners.
We know from the research on ice baths that routinely taking an ice bath after strength workouts actually decreases performance gains. This is thought to be due to reducing the natural inflammatory response needed to complete the muscle repair process.
So we have to ask ourselves … Is it a good idea to use CBD after every training session, or should it only be used in specific situations (like with ice baths)?
This is why more sport-specific research is needed. Indeed, the researchers that did the review study found that:
the CBD studies that have been carried out so far are insufficient to adjudicate whether and to what extent CBD enhances and/or impairs performance, and
there is a lack of experimentation in humans, especially in its effects on athletes and physically active people.
Also, the suspected benefits of CBD for runners must be weighed up against possible side effects, and at this point, due to a lack of sport-specific research, we don’t know what those might be.
CBD effects on the brain
What sets CBD apart from most other (legal) supplements that are claimed to enhance sports performance and/or recovery is its suspected psychological effects.
Reduced stress and anxiety before or during competition might help athletes to perform better. (Although some would argue that a certain level of stress helps performance.)
Post-competition stress (due to tiredness and/or due to a disappointing performance) can impair sleep and therefore recovery.
The researchers who reviewed the science found the following ways in which CBD might help to relieve stress and anxiety:
It has been found to restore the impaired transmission of serotonin to the brain. Serotonin is a “chemical messenger” that induce feelings of well-being.
CBD inhibits the productions of stress hormones such as cortisol.
The research that looked into CBD and sleep quality also found that it helps people to have fewer nightmares.
However, the researchers note that there is “no evidence of reduced anxiety or mood regulation in sports”.
💡What does this mean for runners?
Each to their own, but my feeling is that it is more sustainable to try and remove the cause of the stress or to learn coping mechanisms than to try and combat the stress biochemically once it has taken hold.
However, I also appreciate that this is often easier said than done. CBD may be a useful tool if you need help getting your stress down and to sleep better, but it is not the only tool in the shed.
So, is CBD good for runners?
The short answer is, we don’t know (yet). Much more research is needed, and I hope to return to this article in a few years’ time to rewrite it with much more definitive answers for athletes.
It may be easier to recommend when not to take it:
If it is illegal where you are.
If you’re an athlete subject to doping regulations – see below.
As for CBD helping with post-exercise recovery, there are many other ways to help us recover that have been studied much better, and I would rather use those.
If you do take CBD – how much?
The research review does not go into much detail about CBD dosage, but it does mention the following in passing:
For anxiety, 300 mg of CBD seems to be more effective than 150 mg or 600 mg. (However, the next sentence is where it says there is no evidence that this works in sport situations.)
10 mg of CBD for each kilogram of body weight might help to control inflammation.
CBD and doping
CBD is the only cannabinoid (cannabis-derived substance) that is not prohibited in-competition by the World Anti-Doping Agency (WADA). The reporting threshold for THC in an athlete’s urine is 150 nanograms per millilitre.
However, THC and other cannabinoids (there are about 110 of them!) are often found in CBD, because it is difficult to extract pure CBD from cannabis.
UKAD, the UK’s anti-doping agency, points out that a study in the USA found THC at levels higher than the threshold permitted by WADA in some CBD products. And because there is no threshold for other types of cannabinoid, even the slightest trace of those in CBD will land you in trouble. The fact that you inadvertently ingested the offending substance via CBD, which is an allowed substance, won’t wash with WADA.
How we can help
Need help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.