**6. Conclusions**

In conclusion, a dynamic balance exists within the ECM system from skeletal muscles. Highly regulated cycles of protein deposition, accumulation, remodelling and degradation occur in response to development, fibre transformation, neuromuscular loading, mechanical unload‐ ing, disease processes or aging. The main components of the ECM are represented by collagen fibres, non-fibrillar collagens, matricellular proteins, proteoglycans, matrix metalloproteinas‐ es, signalling molecules and adhesion complexes. The muscle ECM forms a structural scaffold that plays a central role in the maintenance of the physical structure of motor units and provides the framework for force transmission. The ECM is also involved in signalling cascades and adhesion processes at the sarcolemma–matrix interface. The systematic mass spectrometry-based proteomic analysis of the muscle ECM has established an enormous complexity and interconnectivity of matrix proteins and confirmed the dynamic nature of collagen networks and its associated proteoglycans in health and disease. Swift adaptations or alterations in the arrangement of the ECM have been established to occur during myogen‐ esis, fibre regeneration, increased neuromuscular activity or pathological muscle wasting. Hence, concentration changes in ECM proteins are useful indicators for studying basic cell biological or pathophysiological processes in skeletal muscles. In the future, distinct ECM molecules may be useful for designing improved diagnostic, prognostic or therapy-monitoring approaches to study neuromuscular alterations.
