Gait modifications are often proposed to reduce average loading rate (AVLR) during running. While many modifications may reduce AVLR, little work has investigated secondary gait changes. Thirty-two rearfoot runners [16M, 16F, 24.7 (3.3) years, 22.72 (3.01) kg/m(2), >16km/week] ran at a self-selected speed (2.9 +/- 0.3m/s) on an instrumented treadmill, while 3D mechanics were calculated via real-time data acquisition. Real-time visual feedback was provided in a randomized order to cue a forefoot strike (FFS), a minimum 7.5% decrease in step length, or a minimum 15% reduction in AVLR. AVLR was reduced by FFS (mean difference=26.4 BW/s; 95% CI=20.1, 32.7; P<0.001), shortened step length (8.4 BW/s; 95% CI=2.9, 14.0; P=0.004), and cues to reduce AVLR (14.9 BW/s; 95% CI=10.2, 19.6; P<0.001). FFS, shortened step length, and cues to reduce AVLR all reduced eccentric knee joint work per km [(-48.2J/kg*m; 95% CI=-58.1, -38.3; P<0.001), (-35.5J/kg*m; 95% CI=-42.4, 28.6; P<0.001), (-23.1J/kg*m; 95% CI=-33.3, -12.9; P<0.001)]. However, FFS and cues to reduce AVLR also increased eccentric ankle joint work per km [(54.49J/kg*m; 95% CI=45.3, 63.7; P<0.001), (9.20J/kg*m; 95% CI=1.7, 16.7; P=0.035)]. Potentially injurious secondary effects associated with FFS and cues to reduce AVLR may undermine their clinical utility. Alternatively, a shortened step length resulted in small reductions in AVLR, without any potentially injurious secondary effects.