Saw a sports-medicine ortho doc yesterday. He says I have a chronic tendinosis/tendinopathy, and that it finally crossed the threshold into an acute tendinitis condition. Damage and swelling to the sheath, scar tissue, and tangled fibers. My tendons are too tight. Been that way my whole life, and I've always attributed it to my height; growing fast, etc. But whatever the source, I need to fix it or face recurring consequences. I'm on Prednisone, and start PT Monday. That will include "Astym" on the tendons, and stretching regimens for both the tendons and my calf muscles. Tight calf muscles also contribute to Achilles issues.
I tracked this doc down through the Dignity Health (my employer) network, and really like the guy. Sports guys are a different breed. Unlike most doc's you meet at our age, he assumed I was not on any med's, rather than the opposite, and his goal was to treat aggressively and get me back on the bike as quickly as possible. Refreshing.
Good news is I am back on the bike as soon as the pain is gone. It's already way below what I'd call pain, but I'm waiting until tomorrow (started the Prednisone yesterday), and will begin with easy spinning: 100 watt stuff.