Rugby, Recovery, and Regulations: Where does medical cannabis fit in?

Rugby: common injuries and long-term impacts

A high-impact and unforgiving sport, Ruby might be thrilling on the field, but it can also take a huge toll on the body. Whether you have played professionally or just for fun, athletes often experience frequent injuries and the effects of long-term wear and tear. 

Injuries such as sprains, strains, fractures and dislocations are common. As well as being tough to recover from at the time, they also can lead to more serious chronic conditions further down the line. Research from Durham University has even shown that rugby players are more likely than other athletes to suffer long-term injuries, with players continuing to suffer from high ‘injury load’ after retirement.

This can lead to athletes developing chronic pain and inflammatory health conditions. Osteoarthritis, for example, is thought to be twice as common in elite rugby players compared to non-contact athletes, with over half (51-60%) of retired elite rugby players thought to suffer with the condition. Back pain and severe and regular joint pain were also more prevalent in retired professional rugby players.

Professional sport and CBD 

In the quest to find effective relief, some rugby players have endorsed alternative treatments, such as CBD. Some have even gone so far as to launch their own brand in a bid to help others find natural relief. 

Former rugby professionals, Dominic Day and George Kruis, launched fourfiveCBD after struggling to find a product they could trust. While England rugby international, James Haskell, has also spoken about his use of CBD products during his sporting career and teamed up with All Blacks star Ben Franks to launch Impact Sports. 

Over-the-counter CBD products, particularly topicals, can be popular for aiding pain relief and supporting recovery among professional and amateur athletes alike. However, these products are different to the cannabis-based medicinal products (CBMPs), which are prescribed through clinics such as Releaf. 

CBD vs CBMPs

CBD products are legally sold by high street and online retailers, as long as they contain less than 0.2% THC or 1 mg of THC per product container. CBMPs come in various formats, and contain higher levels of THC, as well as other cannabinoids and terpenes. 

All of these compounds are thought to have their own therapeutic effects and work together synergistically— through what is known as the entourage effect—to provide the most effective relief. 

Medical cannabis for chronic pain and inflammation

Medical cannabis is prescribed by specialist doctors at Releaf, for a range of chronic pain conditions such as sciatica and osteoarthritis, if an individual's symptoms have not been effectively managed with conventional treatments. 

Many patients report that it can be beneficial for managing symptoms and improving quality of life. There is also a growing body of evidence to support its use in managing musculoskeletal and neuropathic pain. 

Research on almost 2,000 chronic pain patients, enrolled on Drug Science’s T21 patient registry, found cannabis was associated with marked reductions in pain severity and interference and with improvements in aspects of general health and quality of life. 

While the majority of research is currently based on real-world evidence, there are a small number of randomised control trials, such as this one from 2010, which showed participants experienced pain relief, improved mood and better quality sleep after consuming cannabis.

There is also a growing interest in the use of medical cannabis for long-term injuries and pain in athletes. In 2022, the NFL announced it was committing $1million in funding to investigate the use of cannabinoids for alternative pain management. 

Rules around CBD and THC in sport 

There are strict anti-doping rules when it comes to professional sport. It is crucial that athletes looking to try cannabinoid-based treatments understand the regulations around their use and act accordingly. 

Can athletes use CBD?

Since 2017, the World Anti-Doping Agency (WADA) has permitted the use of CBD by sports professionals. However, their use is not recommended before competitions in case they inadvertently ingest traces of THC or other prohibited cannabinoids, which would violate anti-doping regulations. 

The UK’s Anti-Doping Agency’s (UKAD) position is that CBD products should be considered in the same way as all other dietary supplements and used at the athlete’s own risk.

What do anti-doping laws say about THC?

THC and all other cannabinoids are prohibited in competitive sports. THC has a threshold in urine of 150 nanograms per milliliter, according to UKAD guidelines . As other compounds do not have a reporting threshold, the detection of even the smallest amount in urine will be considered as an Adverse Analytical Finding (AAF).

Rugby Football Union (RFU) has strict policies in place to monitor anti-doping and illicit drugs in players, including carrying out hair testing, as well as urine. Athletes are also said to be subject to out-of-competition tests. 

Professional sporting bodies are yet to publish any guidelines around the use of prescription CBMPs in sport. While it remains unclear how they would respond, professional athletes should err on the side of caution and avoid completely– especially those with matches coming up!

How to get medical cannabis 

If you're a retired athlete and feel medical cannabis could be beneficial for your symptoms, it’s important that you don't make any changes to your treatment plan without consulting a doctor first. 

You can use the Releaf eligibility checker to determine if it's right for you. A team of clinicians will review your application and if appropriate you will be invited to schedule an appointment with a specialist consultant, where you can discuss your symptoms and specific needs. 

You can find out more about medical cannabis via the FAQs page or and read up on its role in treating chronic pain and other conditions.