The NFL and CBD: The Regulations, Uses, and Benefits

Physical challenges and drug use in the major leagues

Playing in the NFL is the pinnacle for all football players; however, the physical demands and sacrifices involved in reaching the top are not commonly understood. Throughout middle and high school football, college football and eventually in the big time, players are subjected to rigorous drills to prove their skills and fitness for the big games. As a contact sport, players are dutifully required to struggle for ball possession, dash hurriedly in different directions, leap suddenly to avoid dispossession, and at some points, physically collide with opponents on the field of play. 

These repeated actions are common to every NFL player and, as such, give a logical explanation for professional players’ injury records. In recent times, different independent reports on the common physical injuries sustained by NFL players have been published. The common injuries, as reported, are orthopedic in nature. It is common to see a professional player out of play for a few weeks due to injuries sustained primarily to the shoulders, back, neck, knee, foot, and fingers. Injuries can also be sustained to different muscles and, in some cases, result in sports hernia. Other injuries documented so far include abdominal injuries, kidney injuries, splenic lacerations, concussions, and pulmonary contusions.  

In January 2020, the NFL published its most recent injury report, as compiled by IQVIA. The injury reports combined data records from preseason and regular season. In 2019, the League recorded 224 cases of concussions, 47 cases of torn ACLs, and 100 cases of torn MCLs. From a broad perspective, the injury rates have increased steadily between 2014 and 2019. Beyond physical injury, the American Journal of Sports Medicine published a report suggesting that a long career in the NFL is associated with a high risk of cognitive impairment coupled with confusion, memory deficit, depression, and anxiety. NFL rules have since made provisions for Team Medical Liaisons and emergency action plans to address cases of injuries. The search for alternative medicine in combating physical injuries has led researchers and medical personnel to suggest cannabis-derived products.

NFL regulation and cannabis products

Cannabis is a complex discussion point for the NFL. Since 2016, professional players have consistently called for a review of the stringent NFL rules prohibiting cannabis use. Drug use in the NFL is regulated by the provisions of the Collective Bargaining Agreement negotiated by a joint NFL-NFLPA committee in 2011. Provisions of this agreement rule that a positive cannabis test results in requiring the player to enroll in a substance abuse program. A second positive test results in a two-game fine. 

Under the original CBA rules, the fail limit for a drug test is set at 15 nanograms per ml; however, the threshold was raised to 35 nanograms in 2014. These limits are strict when compared to the Major League Baseball limit of 50 nanograms and the World Anti-Doping Agency’s limit of 150 nanograms. The current CBA rule is expected to expire at the end of the 2020 season. Talks are in progress for a new agreement that will reduce the drug testing period to two weeks and set a new fail limit at 150 nanograms. These new regulations are expected to change the trend of cannabis use in the NFL and subsequently allow its use for players in need of alternative therapy to opioids. 

Potentials for CBD in combating physical challenges of NFL players

• CBD for concussion therapy

 A concussion is by far the most frequent injury documented in the NFL over the last several of years. Mild traumatic brain injury or concussions are associated with impairments in the cerebrovascular and cardiovascular physiology, and at present, there is no definite treatment approach to enhancing recovery. Cannabinoid-focused research has suggested that cannabidiol influences the blood-brain barrier, neuron regeneration, neurotrophic factors, and the cerebrovasculature. 

In 2012, the Journal of Neuropharmacology published the report of research focused on CBD’s effects on the long-term brain injury and neurobehavioral function in newborn rats following hypoxia-ischemia. The result of this research suggests that CBD reduced brain infarct volume and lessened the extent of histological damage with no significant side effects. In human subjects, hospital charts reviews have shown that medical cannabis effectively relieves concussion-related chronic pain and headaches.

• CBD for muscle recovery

Repeated local exertion of the muscle bundles is considered the primary cause of muscle tear injuries observed in professional players. In most cases tears cause excruciating pain and local inflammation. The evidence supporting CBD’s use in muscle injury is still inconclusive; however, different research findings suggest a potential therapeutic benefit. 

The British Journal of Pharmacology published an early report documenting the effects of non-psychoactive plant cannabinoids on muscle quality and dystrophic mice’s performance. Preliminary reports suggest that plant cannabinoids interact with TRP channels in skeletal muscles to prevent loss of locomotor activity and reduce inflammation. CBD has also been shown to reduce muscle recovery time by building muscle and improving protein synthesis.  

• CBD for bone, accelerating healing of fractures

Bone fractures are directly responsible for the discomfort and prolonged immobilization of professional players. Research evidence supporting cannabidiol’s potential benefit in managing fractures and accelerating bone the bone growth process is rapidly accumulating. Cannabidiol influences bone physiology by activating the cannabinoid receptors in the skeletal system. 

In 2015, the Journal of Bone and Mineral Research published the report of a study investigating CBD’s effects on the structural and mechanical properties of fracture healing. Using closed, unilateral, mid-diaphyseal femoral fractures in rats, the researchers confirmed that that CBD enhances fracture healing and improves bone formation by stimulating the activity of lysyl hydroxylase, an enzyme that catalyzes collagen cross-linking. 

Currently, cannabidiol is gaining wide recognition for the treatment of chronic pain, which can be associated with any injury sustained by professional players. As cannabis regulation changes around the world, more research into cannabidiol’s potential benefits for professional athletes is expected to open up new roles for cannabis products in sports.

REFERENCES

• https://pubmed.ncbi.nlm.nih.gov/22659086/
• https://neurologycentretoronto.com/concussion-and-cannabis-could-cbd-be-used-following-brain-injury/
• https://pubmed.ncbi.nlm.nih.gov/30074247/
• https://pubmed.ncbi.nlm.nih.gov/25801536/
• https://www.playsmartplaysafe.com/newsroom/reports/injury-data/
• https://www.everydayhealth.com/emotional-health/longer-nfl-career-tied-depression-anxiety-cognitive-decline
• https://outwittrade.com/how-to-deal-with-anxiety