Biology of Sport

Chronic co-use of cannabis and tobacco on short-term recovery from eccentric exercise-induced muscle damage: A pilot study

Antoine Mendes 1
,
Gregory Cuvelier 2
,
Léo Duriez 1, 3
,
Pauline Chartreux 2
,
Patrice Maboudou 4
,
Alexandr Gish 5
,
Jean-Michel Gaulier 5
,
Elsa Heyman 1, 6
,
Serge Berthoin 1
,
François-Xavier Gamelin 1

  1. Univ. Lille, Univ. Artois, Univ. Littoral Côte d’Opale, ULR 7369 – URePSSS – Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59000 Lille, France

  2. Laboratoire de l’effort et du mouvement. HEPH-Condorcet – Tournai, 7500 – Belgique

  3. Institut de Recherches Cliniques de Montréal, Montréal, Québec, CANADA

  4. CHU Lille, Service de Biochimie automatisée Protéines, F-59000 Lille, France – Université de Lille, CHU Lille – France

  5. CHU Lille, Unité Fonctionnelle de Toxicologie, F-59037 Lille, France

  6. Institut Universitaire de France, (IUF), Paris 75005, France

Biol Sport. 2027;44:283–292

DOI: https://doi.org/10.5114/biolsport.2026.163921
Data publikacji online: 2026/11/06
Article file
20_05817_Article.pdf
  1. Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse Health Effects of Marijuana Use. N Engl J Med. 2014; 370(23):2219–2227. doi: 10.1056 /NEJMra1402309.
  2. Cohen K, Weizman A, Weinstein A. Positive and Negative Effects of Cannabis and Cannabinoids on Health. Clin Pharmacol Ther. 2019; 105(5):1139–1147. doi: 10.1002 /cpt.1381.
  3. Shah K, Farwa UE, Vanaparti A, et al. Global epidemiology of cannabis use disorders and its trend from 1990 to 2019: Benchmarking analysis of the global burden of disease study. J Family Med Prim Care. 2024; 13(3):881–889. doi: 10.4103/jfmpc.jfmpc_824_23.
  4. Connor JP, Stjepanović D, Le Foll B, Hoch E, Budney AJ, Hall WD. Cannabis use and cannabis use disorder. Nat Rev Dis Primers. 2021; 7(1):16. doi: 10.1038/s41572-021-00247-4.
  5. Leung J, Chan GCK, Hides L, Hall WD. What is the prevalence and risk of cannabis use disorders among people who use cannabis? a systematic review and meta-analysis. Addict Behav. 2020; 109:106479. doi: 10.1016/j.addbeh .2020.106479.
  6. Brellenthin AG, Koltyn KF. Exercise as an adjunctive treatment for cannabis use disorder. Am J Drug Alcohol Abuse. 2016; 42(5):481–489. doi:10.1080/00 952990.2016.1185434.
  7. Farias-Junior LF, Browne RAV, Freire YA, et al. Psychological responses, muscle damage, inflammation, and delayed onset muscle soreness to high-intensity interval and moderate-intensity continuous exercise in overweight men. Physiol Behav. 2019; 199:200–209. doi: 10.1016/j.physbeh.2018.11.028.
  8. Clarkson PM, Hubal MJ. Exercise-Induced Muscle Damage in Humans. Am J Phys Med Rehabil. 2002; 81(Supplement):S52–S69. doi: 10.1097 /00002060-200211001-00007.
  9. Chalchat E, Gaston AF, Charlot K, et al. Appropriateness of indirect markers of muscle damage following lower limbs eccentric-biased exercises: A systematic review with meta-analysis. Ye X, ed. PLoS One. 2022; 17(7):e0271233. doi: 10.1371/journal.pone.0271233.
  10. Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012; 18:42–97.
  11. Trost Z, France CR, Thomas JS. Pain-related fear and avoidance of physical exertion following delayed-onset muscle soreness. Pain. 2011; 152(7):1540–1547. doi: 10.1016 /j.pain.2011.02.038.
  12. Chester LA, Englund A, Chesney E, et al. Effects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Plasma Endocannabinoid Levels in Healthy Volunteers: A Randomized Double-Blind Four-Arm Crossover Study. Cannabis Cannabinoid Res. 2024; 9(1):188–198. doi: 10.1089/can.2022.0174.
  13. Lu HC, Mackie K. An Introduction to the Endogenous Cannabinoid System. Biol Psychiatry. 2016; 79(7):516–525. doi: 10.1016/j.biopsych.2015.07.028.
  14. Dalle S, Schouten M, Meeus G, Slagmolen L, Koppo K. Molecular networks underlying cannabinoid signaling in skeletal muscle plasticity. J Cell Physiol. 2022; 237(9):3517–3540. doi: 10.1002 /jcp.30837.
  15. Finn DP, Haroutounian S, Hohmann AG, Krane E, Soliman N, Rice ASC. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. Pain. 2021; 162(1):S5–S25. doi: 10.1097/j.pain.000000000000 2268.
  16. Iannotti FA, Silvestri C, Mazzarella E, et al. The endocannabinoid 2-AG controls skeletal muscle cell differentiation via CB1 receptor-dependent inhibition of Kv 7 channels. Proc Natl Acad Sci USA. 2014;111(24):E2472–E2481. doi:10.1073/pnas.1406728111.
  17. Le Foll B, Tang VM, Rueda S, Trick LV, Boileau I. Cannabis use disorder: from neurobiology to treatment. J Clin Invest. 2024; 134(20):e172887. doi: 10.1172/JCI172887.
  18. Hindocha C, Freeman TP, Ferris JA, Lynskey MT, Winstock AR. No Smoke without Tobacco: A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit. Front Psychiatry. 2016; 7. doi: 10.3389 /fpsyt.2016.00104.
  19. Nogueira L, Trisko BM, Lima-Rosa FL, et al. Cigarette smoke directly impairs skeletal muscle function through capillary regression and altered myofibre calcium kinetics in mice. J Physiol. 2018; 596(14):2901–2916. doi: 10.1113 /JP275888.
  20. Stevens NE, Loreti M, Ramirez-Sanchez I, et al. Cigarette smoke exposure impairs early-stage recovery from lengthening contraction-induced muscle injury in male mice. Physiol Rep. 2024; 12(18):e70064. doi: 10.14814 /phy2.70064.
  21. Mendes A, Cuvelier G, Anthierens A, et al. Topical application of cannabidiol for muscle recovery after exercise-induced muscle damage: a randomized, double-blinded pilot study. J Cannabis Res. Published online March 25, 2026. doi: 10.1186/s42238-026-00420-0.
  22. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983; 17(1):45–56. doi: 10.1016 /0304-3959(83)90126-4.
  23. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863. doi:10.3389/fpsyg.2013.00863. doi: 10.3389/fpsyg.2013.00863.
  24. Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive Statistics for Studies in Sports Medicine and Exercise Science. Med Sci Sports Exerc. 2009; 41(1):3–12. doi: 10.1249/ MSS.0b013e31818cb278.
  25. Baird MF, Graham SM, Baker JS, Bickerstaff GF. Creatine-Kinase- and Exercise-Related Muscle Damage Implications for Muscle Performance and Recovery. J Nutr Metab. 2012; 2012:1–13. doi: 10.1155/2012/960363.
  26. Baumert P, Temple S, Stanley JM, et al. Neuromuscular fatigue and recovery after strenuous exercise depends on skeletal muscle size and stem cell characteristics. Sci Rep. 2021; 11(1):7733. doi: 10.1038/s41598-021-87195-x.
  27. Tantimonaco M, Ceci R, Sabatini S, et al. Physical activity and the endocannabinoid system: an overview. Cell Mol Life Sci. 2014; 71(14):2681–2698. doi: 10.1007 /s00018-014-1575-6.
  28. Lisano JK, Flores VA, Kisiolek JN, Stewart LK. Regular Use of Cannabis in Female Athletes Is Associated With a Reduction in Early Anaerobic Power Production. J Strength Cond Res. 2023; 37(3):616–622. doi: 10.1519 /JSC.0000000000004297.
  29. Lisano JK, Smith JD, Mathias AB, et al. Performance and Health-Related Characteristics of Physically Active Males Using Marijuana. J Strength Cond Res. 2019; 33(6):1658–1668. doi: 10 .1519/JSC.0000000000002238.
  30. Byrne C, Eston RG, Edwards RHT. Characteristics of isometric and dynamic strength loss following eccentric exercise-induced muscle damage. Scand J Med Sci Sports. 2001; 11(3):134–140.
  31. McLeay Y, Barnes MJ, Mundel T, Hurst SM, Hurst RD, Stannard SR. Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage. J Int Soc Sports Nutr. 2012; 9(1):19. doi: 10.1186/1550-2783-9-19.
  32. Linnamo V, Moritani T, Nicol C, Komi PV. Motor unit activation patterns during isometric, concentric and eccentric actions at different force levels. J Electromyogr Kinesiol. 2003; 13(1):93–101. doi: 10.1016 /S1050-6411(02)00063-9.
  33. Hirvonen J, Goodwin RS, Li CT, et al. Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers. Mol Psychiatry. 2012; 17(6):642–649. doi: 10.1038 /mp.2011.82.
  34. Peake JM, Neubauer O, Della Gatta PA, Nosaka K. Muscle damage and inflammation during recovery from exercise. J Appl Physiol. 2017; 122(3):559–570. doi: 10.1152 /japplphysiol.00971.2016.
  35. Luo Y, Zheng SG. Hall of Fame among Pro-inflammatory Cytokines: Interleukin-6 Gene and Its Transcriptional Regulation Mechanisms. Front Immunol. 2016;7:604. doi:10.3389/ fimmu.2016.00604.
  36. Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation. Nat Rev Rheumatol. 2015; 11(2):86–97. doi: 10.1038/nrrheum.2014.193.
  37. Pedersen BK, Febbraio MA. Muscle as an Endocrine Organ: Focus on Muscle-Derived Interleukin-6. Physiol Rev. 2008; 88(4):1379–1406. doi: 10.1152/physrev.90100.2007.
  38. Alshaarawy O, Sidney S, Auer R, et al. Cannabis Use and Markers of Systemic Inflammation: The Coronary Artery Risk Development in Young Adults Study. Am J Med. 2019; 132(11):1327–1334.e1. doi: 10.1016/j.amjmed.2019.04.045.
  39. Ibarra-Lecue I, Unzueta-Larrinaga P, Barrena-Barbadillo R, et al. Cannabis use selectively modulates circulating biomarkers in the blood of schizophrenia patients. Addict Biol. 2022; 27(6):e13233. doi: 10.1111 /adb.13233.
  40. Kraft B, Gustorff B. Lack of Analgesia by Oral Standardized Cannabis Extract on Acute Inflammatory Pain and Hyperalgesia in Volunteers. Anesthesiology. 2008; 109(1):101–110. doi: 10.1097 /ALN.0b013e31817881e1.
  41. Schindler EAD, Schnakenberg Martin AM, Sewell RA, et al. In an exploratory randomized, double-blind, placebo-controlled, cross-over study, psychoactive doses of intravenous delta-9-tetrahydrocannabinol fail to produce antinociceptive effects in healthy human volunteers. Psychopharmacology (Berl). 2020; 237(10):3097–3107. doi: 10.1007/s00213-020-05595-9.
  42. Wallace M, Schulteis G, Atkinson JH, Wolfson T, Lazzaretto D, Bentley H, et al. Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers. Anesthesiology. 2007;107(5):785–796. doi:10.1097/01. anes.0000286986.92475.b7.
  43. Sajdeya R, Rouhizadeh M, Cook RL, et al. Cannabis use and acute postoperative pain outcomes in older adults: a propensity matched retrospective cohort study. Reg Anesth Pain Med. 2025; 50(10):771–778. doi: 10.1136/rapm-2024-105633.
  44. Zhang-James Y, Wyon E, Grapsas D, Johnson B. Daily cannabis use may cause cannabis-induced hyperalgesia. Am J Addict. 2023; 32(6):532–538. doi: 10.1111/ajad.13456.
  45. Degens H, Gayan-Ramirez G, Van Hees HWH. Smoking-induced Skeletal Muscle Dysfunction. From Evidence to Mechanisms. Am J Respir Crit Care Med. 2015; 191(6):620–625. doi: 10.1164 /rccm.201410-1830PP.
Copyright: Institute of Sport. This is an Open Access article distributed under the terms of the Creative Commons CC BY License (https://creativecommons.org/licenses/by/4.0/). This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.
SUBMIT YOUR PAPER
Share
without publication fees
Integrated with
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications