Dear Nurse Susan,
I am an executive that works long hours during the week, mostly behind my desk. On weekends, I like to get lots of exercise, and I recently injured my back. This injury is interfering with my activities and stamina at work and on weekends. Is cannabis good for sports injuries and is it possible to use it without getting high?
Stiff & Tired
Dear Stiff and Tired,
Whether you are a professional athlete, or a weekend athlete, cannabis is a good treatment for pain, inflammation, and muscle spasms, the usual suspects with sports injuries. Attempting to select the best products or strains that will relieve these issues is like putting together a puzzle. You want to match the best cannabinoids and terpenes with each condition, select the best method(s) of ingestion, and find your best dose.
So, we begin by identifying the best cannabinoids and terpenes for each of these conditions.
- Inflammation: There are several compounds in the cannabis plant that relieve inflammation including the cannabinoids THCA, THC, and CBD, and the terpenes caryophyllene, myrcene and pinene.
- Muscle spasms: The compounds in the cannabis plant that relieve muscle spasms include the cannabinoids THC, CBD, and CBG, and the terpenes a-terpinolene, linalool, and myrcene.
- Pain: Cannabis is an excellent pain reliever. The cannabinoids that best address pain are THC, CBD, and THCV, and the terpenes myrcene, linalool and pinene.
Next, we will consider all these compounds together, and prioritize compounds that address all three of these conditions and they include THC, CBD, and myrcene. The compounds that address 2 out of 3 conditions include pinene and linalool. So, you want to use a product or products that contain THC, CBD, myrcene, linalool and pinene.
Often the most effective cannabis protocol requires the use of more than one product. Your desire to avoid the “high” or psycho-activity produced by THC is the perfect example of why you will want to use more than one product. Clearly THC is effective for managing pain, inflammation and muscle spasms, but it does come with dose-dependent psycho-activity. If you use a product with THC, linalool and myrcene (all are sedating) at night only, you will not feel the high and your sleep will most likely improve. During the day, use a product that has CBD and pinene which are not sedating.
Now that you know which compounds are best for these conditions, you can go to your local dispensary and ask to see products for daytime use that are high in CBD and pinene, and products for nighttime use that have THC, myrcene and linalool.
There are several methods of ingestion to choose from: inhalation, topicals, suppositories, edibles etc. Most of my clients prefer using tinctures and topicals to manage sports related injuries. I usually don’t recommend smoking due to the irritation caused by the products of combustion. If they need immediate relief, vaping is a good alternative.
Dosing is the most important factor in having a successful experience with cannabis: if you take too much you will feel uncomfortable, and if you take too little it will be ineffective at managing your symptoms. The rule of thumb is to start with a low dose (~2.5 mg) and slowly titrate up until you are getting the results you need. If you start feeling worse with the newly increased dose, then you know it is too much for you, and you back down to the prior dose.
So, Stiff and Tired, cannabis is a safe medicine when used strategically and responsibly, that can be used to manage your sports injuries. So much so, that many professional athletes support using cannabis for injuries as well as helping them endure the demands of the game. See the links below to learn more about what some professionals think about cannabis.
To your health and better pain management,
(Susan Marks RN, BSN, PHN writes for CityWatch and is a medical cannabis educator and consultant based in Los Angeles. You can contact her at firstname.lastname@example.org)