Purpose The purpose of the study is to compare the effects of total cold-water immersion to ice massage on muscle damage, performance, and delayed onset of muscle soreness. Methods Sixty participants were randomized into two groups where they completed a muscle damage protocol. Afterward, muscle damage, muscle performance, and delayed onset muscle soreness were respectively measured by serum Creatine Kinase (CK) test, one-repetition maximum (1-RM) test, countermovement jump (CMJ) test, and visual analog scale (VAS). The measurements were taken at five different timelines (Baseline, 2 H, 24 H, 48 H, and 72 H). Results Data showed that values of all within-group measures of the dependent variables had extremely significant statistical differences (p < 0.001) for both intervention groups. Serum CK values peaked at 24 H for both groups. At 72 H, serum CK values dropped to baseline values in the total cold-water immersion group, while remaining high in the ice massage group. At 72 H, the values of the 1-RM test, CMJ test, and VAS approximated baseline values only in the total cold-water immersion group (p < 0.001). Conclusions Total cold-water immersion (TCWI) was more effective when compared to ice massage (IM) on improving values of recovery from exercise-induced muscle damage (EIMD). Hence, this modality may be considered during athletic recovery to maximize athletic performance. Clinical trial registration This trial was registered in ClinicalTrials.gov under the trial registration number (NCT04183816).

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