Extracorporeal shock wave therapy (ESWT) has shown promise in treating musculoskeletal conditions, but its application to muscle lesions remains relatively understudied compared to its use in tendon and joint pathologies. Given that ESWT aims to stimulate tissue regeneration, its potential benefit for muscle injuries is substantial, suggesting a likely expansion of its clinical use in this area. This review explores the existing literature on ESWT for muscle lesions, aiming to identify potential future applications. Specifically, we examine two key areas: the use of ESWT for improving muscle flexibility and its efficacy in promoting muscle damage recovery.