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Structured multicomponent injury prevention programs (IPP) are efficacious for reducing lower extremity (LE) injury risk in athletes, but are not commonly used by high school athletic team coaches in the United States. One barrier to structured IPP adoption is that many coaches report that they incorporate IPP activities into their team’s training, and therefore may not perceive IPPs to present any relative advantage over their current practices.To determine if teams whose coaches report including self-selected activities that meet current IPP recommendations have lesser LE injury rates than teams that do not.Training and competition injury events and athletic exposures (AE) of 3853 participants on 274 high school basketball and soccer teams in the U.S. state of Oregon were recorded by sports medicine professionals at 30 high schools for one athletic season. Coaches of 116 of these teams (42%) completed an online survey about their team’s activities that was used to determine whether these activities met minimum IPP recommendations. LE injury rates were compared between teams that met or did not meet current recommendations.Teams whose coaches completed the survey had similar LE injury rates (1.32 injuries/1000AEs) compared to teams with non-responsive coaches (1.04 injuries/1000AEs) (Mean difference: 0.28 injuries/1000AEs (95% CI: −0.08 to 0.65), p=0.134). The LE injury rate of teams whose coaches reported meeting IPP recommendations (1.46 injuries/1000AEs, n=77) was not significantly different than teams whose coaches did not (1.05 injuries/1000AEs, n=39) (Mean difference: 0.42 injuries/1000AEs (95% CI: −0.20 to 1.04), p=0.186).Coach-reported use of activities that meet current IPP recommendations is not protective against LE injury. This suggests that 1) coaches’ reports of IPP use may overestimate actual exposure to protective IPP elements, or 2) minimum IPP recommendations may not be stringent enough to facilitate a protective effect in high school athletes.