Transition to forefoot strike reduces load rates more effectively than altered cadence

•Forefoot strike gait retraining reduced load rates 3 times more than increased cadence.•Increased cadence gait retraining resulted in small load rate reductions.•Reduced load rates with forefoot strike gait persisted for 6 months.•Clinicians should incorporate a pre-gait retraining strengthening program.•Encourage patients to use a slow transition once gait retraining is completed.