You have my sincere empathy. As someone who has been athletic all my life I can truly understand the frustration of being tossed into unfamiliar territory of being sidelined. Having read one of your earlier posts you mentioned that walking actually helped somewhat but that intense exercise really exacerbates the pain. You’re currently training for an Ironman competition so I’m guessing you’re not unfamiliar with pain and possible sports related injuries. The first thing that comes to mind is “Listen to your body” and perhaps back out of the competition this year. The last thing you wanted to hear. But it might give your body the opportunity to heal by not putting strain on the muscles/tendons attached to the aspiration area. Treat this like a sports injury where you need to be out for a while, do some PT and then move forward. If it helps, you may avoid permanent injury and get some relief or find out that it is ongoing, then follow through with a plan of action.