The health of a tissue requires that blood flow be matched to the tissues metabolic demand. This matching is particularly important in tissues such as skeletal muscle where tissue metabolism can change dramatically. This chapter discusses how blood flow is matched to metabolic demand beginning with the microvascular architecture that facilitates this matching, the processes of skeletal muscle-microvascular communication, intravascular communication and other processes involved increasing blood flow to active skeletal muscle fibres. Increases in metabolic activity can result in muscle fibre damage and vascular damage. Contraction- or exercise-induced muscle injury, due to intensive, unaccustomed, and/or eccentric exercise, can lead to structural and cellular muscle damage. Muscle can also be damaged through destruction-induced injuries, such as blunt force trauma or crush injury experienced commonly in contact sports. In both types of injury, blood vessels are also damaged and blood flow is disrupted. But blood flow is required to aid in the recovery and repair of the damaged tissue. This chapter reviews the microvascular disruption resulting from both exercise- and destruction-induced muscle damage and discusses what is currently known about the processes of microvessel repair and recovery post-injury that will be required for skeletal muscle fibre repair and recovery.