This review summarises the treatment of acute muscle injuries. Muscle injuries are frequent traumatic injuries caused by either excessive strain on the muscle tendon unit (strain injury) or a forceful blow to the muscle (contusion). An early start of rehabilitation after acute strain injuries is a key to shortening the time to return to sport. The application of ice, compression and elevation is well tolerated by patients, but there is no evidence that these methods enhance tissue repair. Complications after strain injuries include risk of recurrence, muscle atrophy and development of scar tissue. Ectopic bone formation may, however rarely, occur after severe contusion injuries.