Administration of recombinant human insulin-like growth factor-I (rhIGF-I) has beneficial effects in animal models of muscle injury and muscular dystrophy. However, the results of these studies may have been confounded by interactions of rhIGF-I with endogenous IGF-binding proteins (IGFBPs). To date, no study has examined whether inhibiting IGFBP interactions with endogenous IGF-I can improve muscle fiber regeneration or muscular pathologies. We tested the hypothesis that reducing IGFBP interactions with endogenous IGF-I would enhance muscle regeneration after myotoxic injury and improve the dystrophic pathology in mdx mice. We administered an IGF-I aptamer (NBI-31772; 6 mg/kg per day, continuous infusion) to C57BL/10 mice undergoing regeneration after myotoxic injury or to mdx dystrophic mice. NBI-31772 binds all six IGFBPs with high affinity and releases "free" endogenous IGF-I. NBI-31772 treatment increased the rate of functional repair in fast-twitch tibialis anterior muscles after notexin-induced injury as evidenced by an increase in maximum force producing capacity (P o ) at 10 days after injury. In contrast, NBI-31772 administration for 28 days did not alter P o of extensor digitorum longus (EDL) and soleus muscles or normalized force of diaphragm muscle strips from mdx mice. Although IG-FBP inhibition reduced the susceptibility of the fasttwitch EDL and the diaphragm muscle to contractionmediated damage, it increased muscle fatigability during repeated maximal contractions. Skeletal muscle injury and degeneration can result from trauma caused by mechanical (laceration, crush, strain), chemical (myotoxin), or metabolic (temperature) factors and is a major contributor to the etiology of myopathies, such as the muscular dystrophies. Although muscle fibers have an inherent capacity to regenerate when damaged, the regeneration process is often slow, inefficient, and incomplete with respect to functional restoration.