Fig. 5From: Muscle architecture, growth, and biological Remodelling in cerebral palsy: a narrative reviewMechanical injury is the first step in muscle regeneration and growth and initiates a cascade of cellular and molecular events in skeletal muscle. Inflammatory cells debride tissue and clear damaged muscle cells. Release of appropriate cytokines activates resident satellite cells to repair the fibre while fibroblasts remodel the ECM. CP muscle displays increased expression of TNF-a, TGF-B, IL-6 and myostatin, and fewer SCs. Increases in fibroblast activity result in smaller fibres and excess ECM. Figure by Stephanie Khuu/ CC BY 4.0Back to article page