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125

EXERCISE EFFECTS ON MUSCLE STEM CELLS

Mihaela JURDANA1

1University of Primorska, Faculty of Health Sciences, Izola, Slovenia

Corresponding author: 
Mihaela JURDANA, PhD, 

University of Primorska, Faculty of Health Sciences Izola, Polje 42, 6310 Izola, Slovenia. 
Tel.: +386 5 66 26 469

e-mail: mihaela.jurdana@fvz.upr.si

ABSTRACT

Satellite cells are skeletal muscle stem cells that facilitate muscle repair and regen-
eration after “damage” which occurs after physiological stimuli: exercise, post-train-
ing micro-injuries and electrical stimulation. Exercise stimuli lead to activation and 
proliferation of these cells from their quiescent state, therefore, increasing cell numbers 
having the potential to provide additional myonuclei to their parent muscle fibre or 
return to a quiescent state. Different exercise modalities are the focus of numerous stud-
ies on satellite cells activation. An increase in muscle activity augments satellite cells 
proliferation as well as skeletal muscle mass and function, both in young and elderly. 

This review provides an updated view of the contribution of skeletal muscle satellite 
cells in regulating skeletal muscle mass and the efficiency of the exercise intervention 
to attenuate the decline in muscle mass.

Keywords: Satellite cells, acute and chronic exercises, micro damage, muscle re-
generation.

UČINEK TELESNE AKTIVNOSTI NA SKLETNO-MIŠIČNE 
STAMINALNE CELICE

IZVLEČEK 

Satelitske celice so skeletno-mišične staminalne celice, ki omogočajo popravilo in 
regeneracijo mišičnih vlaken po mikropoškodbah, kot je telesna aktivnost, trening ali 

Review article             UDC: 612.74:796.012
received: 2017-05-31

mailto:mihaela.jurdana@fvz.upr.si


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ANNALES KINESIOLOGIAE • 8 • 2017 • 2

električna stimulacija. Telesna aktivnost sproži prehod satelitskih celic iz stanja miro-
vanja v aktivacijo in proliferacijo, kar jim omogoča, da se namnožijo in povečajo svoje 
število. Novonastale satelitske celice se lahko vežejo na matično mišično vlakno ali 
preidejo v stanje mirovanja. Veliko študij preučuje, kako različne oblike vadbe vplivajo 
na aktivacijo satelitskih celic ter njihovo število.

Znano je, da mišična aktivnost povečuje proliferacijo satelitskih celic, posledično 
tudi mišično maso in funkcijo, tako pri mladih kakor tudi pri starejših osebah. Pregled 
literature v tem članku prikazuje posodobljen pogled na vlogo satelitskih celic pri vzdr-
ževanju mišične mase in pomembnost vloge telesno/gibalne aktivnosti v preventivi pred 
izgubo le-te.

Ključne besede: Satelitske celice, akutna in kronična vadba, mikro poškodbe, mi-
šična regeneracija

INTRODUCTION

Skeletal Muscle Regeneration

Skeletal muscle regeneration is a highly integrated process involving the activation 
of various cellular and molecular responses; skeletal muscle stem cells play a pivotal 
role in this process. 

Adult skeletal muscle is a stable post-mitotic tissue, small daily injury can be re-
paired without causing inflammatory responses and cell death. Muscle injury such as 
extensive physical activity is related to myofibre necrosis, inflammatory responses, and 
activation, differentiation, and fusion of satellite cells. Muscle regeneration includes 
the above mentioned processes with a new myofibre formation. Mammalian skeletal 
muscles consist of different multinucleated myofibers, grouped in slow (type 1) and 
fast types (2A, 2X, and 2B) with different myosin heavy chain (MyHC) composition. 
Myofibres also differ in their metabolic profile, extending from slow /oxidative to fast 
/ glycolytic (Schiaffino & Reggiani, 2011).

The maintenance of skeletal muscle mass depends on mono nucleated muscle pre-
cursors or muscle satellite cells. In addition, pericytes, resident in small vessels of ske-
letal muscle, contribute to its growth and regeneration during postnatal life (Dellavalle 
et al., 2011). Satellite cells were identified over 50 years ago through electron micro-
scopy by Mauro in 1961. The satellite cell population varies by age, muscle type, and 
activity, and are used during muscle regeneration and repair due to their special self-
-renewal and multi-differentiation capabilities. At birth, satellite cells account for 15 
% of the entire myofibre nuclei population (Thornell, Lindström, Renault, Mouly, & 
Butler-Browne, 2003). That proportion latter decreases to between 1 % and 6 % of total 
myonuclear content in mature muscle fibres (Roth et al., 2000). The major function 
of satellite cells is contribution to the maintenance of muscle mass, regeneration, and 



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Mihaela JURDANA: EXERCISE EFFECTS ON MUSCLE STEM CELLS ..., 125–135

hypertrophy by differentiating into myocytes during human’s lifespan. Satellite cells 
are normally non-proliferative, mitotically quiescent and they become activated in re-
sponse to stimuli such as myotrauma upon injury or muscle growth (Bischoff & Heintz, 
1994), or when skeletal muscle tissue is heavily used during physical activities such as 
weight lifting or running. 

When skeletal muscle is injured, damaged or exercised, satellite cells are activa-
ted from their quiescent state, proliferated and fused into existing fibres to provide 
new myonuclei or return to quiescence (Dhawan & Rando, 2005). Activation of those 
cells is not restricted to the site of muscle damage. Satellite cells are activated, migrate 
and proliferate from different parts of myofibre. However, the number of satellite cells 
appears to increase in the end part of myofibres, where longitudinal elongation of the 
skeletal muscle occurs (Yin, Price, & Rudnicki, 2013).

Importantly, satellite cells have a limited capacity of division entering a state of 
irreversible growth arrest after a finite number of cell division (Chargé & Rudnicki, 
2004). The self-renewing proliferation of satellite cells maintains the stem cell popu-
lation and provides abundant myogenic cells which proliferate, differentiate, and fuse 
to generate new myofibre formation (Yin et al., 2013). With these additional nuclei, 
muscle fibres can synthesize more proteins and create more contractile myofilaments 
(actin and myosin) in skeletal muscle cells (Chargé & Rudnicki, 2004). It is interesting 
to note that high numbers of satellite cells are found associated to slow-twitch muscle 
fibres as compared to fast-twitch muscle fibres within the same muscle, as they are 
regularly going through cell maintenance repair from daily activities (Martin & Lewis 
2012). As satellite cells are constantly replenished during lifetime and are essential for 
muscle fibre maintenance, a decline in number and reduced proliferative capacity of 
satellite cells and / or their inability to become activated and proliferate upon stimuli 
might contribute to muscle fibre atrophy observed in the elderly (Bischoff, 1994; Seale 
& Rudnicki, 2000).

Many researchers are interested in new training programs and exercise for deve-
loping skeletal muscle mass. However, the mechanism(s) by which exercise induces 
skeletal muscle hypertrophy remain poorly understood. Through exercise, the muscular 
work done against progressively challenging overloads leads to increases in muscle 
mass. 

Individual satellite cells respond to exercise and they are influenced by such factors 
as training status, age, nutrition, and the intensity and volume of the exercise. Duration, 
frequency and intensity of exercise are important contributing factors in satellite cells 
activation. Passive stretching of contracted muscles may cause multiple micro dam-
ages, disruption of contractile elements or necrosis. For many of us, this happens after 
changes in the locomotor behaviour by severe onset of exercise. Also after 20 minutes 
of stepping up and down induces a remarkable increase in muscle-derived proteins in 
plasma, which reflects some muscle damage (Wernig, 2003). It has been shown that the 
intensity of the exercise is an important factor in satellite cells activation and muscle 
regeneration (Martin & Lewis, 2012). Similarly, other researchers have demonstrated 
that an increase in satellite cell content depends on the intensity rather than the duration 



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ANNALES KINESIOLOGIAE • 8 • 2017 • 2

of exercise (Bazgir, Fathi, Rezazadeh Valojerdi, Mozdziak, & Asgari, 2017). Intensive 
exercise such as resistance training bout induces damage to the muscle fibres, caus-
ing activation and proliferation of satellite cells. This biological effort often leads to 
increasing in muscle fibre cross-section area or hypertrophy (Bischoff, 1994). On the 
other hand, various muscle groups and types react differently to intensity and volume 
of exercise.

During muscle hypertrophy, muscle fibre size appears to be related to the size of 
the myonuclear domain, defined as the amount of cytoplasm within a muscle fibre 
controlled by single myonuclei (Hall & Ralston, 1989). Protein synthesis of single my-
onuclei is confined in myonuclear domain. The amount of cytoplasm controlled by 
each myonuclei in adult muscle fibre is relatively constant, thus supporting the theory 
that satellite cells are required for muscle hypertrophy in order to keep the myonuclear 
domain constant. Considering the presence of other stem cells in skeletal muscle, their 
contribution in muscle regeneration and hypertrophic growth is possible (Blaauw & 
Reggiani, 2014).

METHODS

Electronic databases MEDLINE, PubMed, and Science Direct including the articles 
published up to 2017 were used to search literature sources. Different keywords were 
used: satellite cells (SC), SC during exercise, skeletal muscle regeneration and hyper-
trophy, SC during ageing. Based on the keywords and review articles, satellite cells 
activation and proliferation during exercise was described.

RESULTS

Satellite Cell during Ageing 

It is well known that impairments in satellite cell function during aging result in 
an impaired muscle fibre regenerative response (Sousa & Muñoz-Cánoves, 2016; 
Snijders & Parise, 2017) leading to the gradual loss of muscle mass and function 
(sarcopenia) which diminishes muscle recovery after injury in elderly individuals. In 
many cases this leads to disability and the subsequent loss of independence. A lower 
number of satellite cell pool and the exhausted proliferative capacity of aged satellite 
cells may contribute to accelerated loss of skeletal muscle mass during ageing (Re-
nault, Thorne, Eriksson, Butler-Browne, & Mouly, 2002; Sajko et al., 2004; Joanisse, 
Nederveen, Snijders, McKay, & Parise, 2017). Other possible reasons for impaired 
muscle recovery in elderly individuals relate to the reduced production of growth fac-
tors or affect the e−c (excitation−contraction) coupling mechanism (muscle-contrac-
ting mechanism), (Delbono, O’Rourke, & Ettinger, 1995). It has also been demon-
strated that inadequate muscle fibre vascularization occurring during ageing process 



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may be an important cause of impaired regulation of satellite cells in older adults 
(Snijders & Parise, 2017). 

A certain number of satellite cells seems to be necessary for muscle regeneration 
during the ageing process. Bengal’s recent review (Bengal, Perdiguero, Serrano, & 
Muñoz-Cánoves, 2017) has identified the network of cell-intrinsic and cell-extrinsic 
factors and processes contributing to satellite cells decline during ageing. Most of the 
studies suggest that the mentioned decline is caused by age-associated extrinsic (envi-
ronmental changes) and intrinsic mechanisms (DNA damage, oxidative stress). Both 
mechanisms contribute to muscle stem cell dysfunction. Based on this idea, many stud-
ies propose to rejuvenate aged satellite cells to improving muscle repair in the elderly. 
(Rando & Chang, 2012; Bengal et al., 2017). Other studies proposed that inadequate 
activation of Notch signalling, necessary for cell proliferation and cell fate determina-
tion, contributes to the loss of regenerative proprieties of aged skeletal muscle (Conboy, 
Conboy, Smythe, & Rando, 2003; Bjornson et al., 2012). 

Satellite Cells Activation and Proliferation after Exercise

Resistance and endurance types of exercise training improve muscle mass and 
strength, and increase the performance capacity in young and elderly. Satellite cells are 
involved in muscle maturation during postnatal development, regeneration after injury, 
hypertrophy, hyperplasia and atrophic post-muscle recovery (Dhawan & Rando, 2005; 
Chargé & Rudnicki, 2004). The increase of satellite cell proliferation and activation 
takes place after short-term muscle activity (Darr & Schultz, 1987), but the increases 
in satellite cell numbers only occur after a long term resistance or endurance training 
(Martin & Lewis, 2012).

Many studies reported the result of a number of satellite cells following exercise 
in human (Table 1). Satellite cells get activated from their quiescent state and are 
involved in muscle regeneration after micro-injuries that follow exercise. Satellite 
cell content and activity after endurance training can be correlated with time and 
intensity, duration and frequency of exercise. It has been observed that satellite cell 
content increased after 30 to 155 minutes of moderate to high-intensity endurance 
exercises (Parise, McKinnell, & Rudnicki, 2008; Van de Vyver & Myburgh, 2012; 
Bazgir et al., 2017), while no such increase was associated after 30 minutes of low-
-intensity exercise (Smith, Maxwell, Rodgers, McKee, & Plyley, 2001). These data 
confirm the role of the intensity of exercise in satellite cell activation and their role in 
regeneration and muscle repair. 

The acute satellite cell response to exercise has been examined in humans using 
maximal eccentric contractions of the vastus lateralis muscle by isokinetic dynamom-
etry, as eccentric exercise is considered to induce maximal levels of muscle damage 
(Gibala, MacDougall, Tarnopolsky, Stauber, & Elorriaga, 1995). Indeed, it appears 
that the satellite cell response to acute exercise in humans occurs during the first 24 
hours after eccentric exercise, however, there was a significant increase in satellite cells 



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Table 1: Summarized studies on human satellite cell numbers following different exer-
cise type (Martin & Lewis, 2012).

Acute/chronic
Training Exercise type Muscle 

Analysed                   
Satellite         
 Cell number  References

Acute exercise 
training RT VL increase Crameri et   al. 

2004

RT VL increase Dreyer et al. 
2006

RT VL increase O’Reilly et al. 
2008

RT VL increase McKay et al. 
2009

ES VL increase Mackey et al. 
2012

increase Mackey et al. 
2009

Chronic training RT VL increase Roth et al. 
2001

RT VL # increase Petrella et al. 
2008

RT VL increase Mackey et al. 
2010

RT VL increase Kadi et al. 
2004

RT VL increase Mackey et al., 
2007

RT VL increase Verdijk et al. 
2009

RT TR increase Kadi and Thor-
nell, 2000

RT, ET EDL, VL increase Verney et al. 
2008

ET Pl * increase Kurosaka et al. 
2011

ET VL increase Charifi et al. 
2003

ET VL increase Shefer et al. 
2010

Abbreviations: 
RT= Resistance training, ET= Endurance training, EDL= Extensor digitorum longus, ES= Elec-
trical stimulation, VL=Vastus lateralis, Pl= Plantaris, Tr= Trapezius, 
* increase of SC number only with high intensity training.
# increase of SC number only seen in individuals who responded most robustly to RT.



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over pre-exercise values even at later times (O’Reilly et al., 2008). Therefore, satellite 
cells get activated and proliferated in 24 hours after exercise, and increase consider-
ably between 72 and 96 hours, thereafter they decline in number. (McKay et al., 2009; 
O’Reilly et al. 2008).

The research data on humans suggest that resistance and endurance training can 
increase satellite cell content and activation in response to exercise periods from 9 to 16 
weeks. (Kadi, Charifi, Denis, & Lexell, 2004; Petrella, Kim, Mayhew, Cross, & Bam-
man, 2008; Shefer, Rauner, Yablonka-Reuveni, & Benayahu, 2010). However, it should 
be noted that the resistance type of training leads to an expansion in satellite cell pool 
with myonuclear addition (Petrella et al., 2008). Muscle fatigue seems to be a stimulus 
for activation, proliferation and differentiation of satellite cells. Unfortunately, there is 
little research available that compares satellite cells quantity in response to endurance 
exercise and resistance exercise. Verney et al. (2008) observed an increase in satellite 
cell content in the deltoid (resistance-trained) and VL (endurance-trained) muscles after 
14 weeks in elderly individuals. Interestingly, a failure in increasing the satellite cell 
pool after a training intervention was observed in obese, diabetic population (Snijders, 
Verdijk, Hansen, Dendale, & van Loon, 2011).

As to animal models, a study on rat soleus muscle showed no increase in satellite 
cell content after one week of running for 30 minutes per day on treadmill (Smith et 
al., 2001). While a similar study on mice anterior tibialis muscle reported a significant 
increase in the satellite cell number and activation (Parise et al., 2008), due to the diffe-
rent composition of muscle fibre type. The study of Smith and Merry (2012) described 
a six-week resistance type or endurance type of exercise in rats and found no difference 
between the proportional gains in satellite cell number of the same muscles between 
groups. These data suggest that endurance and resistance training enhance the satellite 
cell pool to a similar extent (Marin & Lewis 2012). In addition, a differential response 
in fibre-type expansion of satellite cells in response to exercise was observed. Fibre-
-type classification demonstrates that satellite cells are not equally distributed among 
the various fibre types and muscles. In human studies, no difference has been detected 
in satellite cell numbers between fibre types in vastus lateralis untrained muscle of 
young healthy individuals (Kadi et al., 2006; Verdijk et al., 2007; Snijders et al., 2012), 
while other studies revealed a greater number of satellite cells in type I fibres and, 
consequently, minor adaptive potential (Martin & Lewis, 2012; Bazgir et al., 2017). It 
was demonstrated that untrained rodent muscle type I fibres contain a greater number 
of satellite cells in respect to type II fibres. In response to training, the number of sa-
tellite cells in type II fibre was increased, while the same increase was not observed in 
type I (Verdijk et al., 2009; Smith & Merry, 2012). This process seems sensible as type 
II fibres give a greater contribution to muscle mass (hypertrophy) and show a higher 
responsiveness to resistance training (Martin & Lewis 2012; Bazgir et al., 2017). All 
these data underline the need of future investigation because the mechanisms of exerci-
se-induced satellite cells activation are not completely understood.



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CONCLUSION

The maintenance of skeletal muscle mass and regenerative capacity depends on a 
functional pool of muscle satellite cells. A loss of skeletal muscle satellite cells and de-
fects in their activity are associated with a variety of neuromuscular and other disorders 
which lead to muscle atrophy. 

Exercise training has been successfully applied to augment satellite cells muscle 
mass and improve muscle function also in elderly. It has been demonstrated that satel-
lite cell activation after exercise together with adequate nutrition are the most effective 
countermeasures for ageing sarcopenia. 

Modalities of exercise, intensity, duration and frequency are correlated with satel-
lite cell content. They are activated and proliferate after acute exercise training, and 
are increased in number after resistance and endurance training. There are still some 
discrepancies between the role of volume and the intensity of exercise on satellite cells 
activation. To clarify the optimal exercise stimuli for satellite cell activation and diffe-
rentiation, further research is required. 

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