The present invention relates to the identification of two microRNAs, miR-499and miR-208b, that repress fast skeletal muscle contractile protein genes.Expression of miR-499 and/or miR-208b can be used to repress fast fiber genesand activate slow fiber genes in the treatment of musculoskeletal disorders.Inhibition of miR-499 and/or miR-208b is proposed as a treatment for cardiachypertrophy, myocardial infarction, and/or heart failure. Pharmaceuticalcompositions comprising antagonists and agonists of miR-499 and miR-208b functionare also disclosed.