FWIW
One of the most common hiking and athletic injuries is achilles tendonitis/tendonosis. I've had to deal with bouts of it the last 4-5 years, followed all the recommended treatments and stretching exercises. I had to cut a section hike short about 3 months ago when it got so bad I was limping the last 3 days, felt like I had a nail driven in my heel with every step.
2 months of PT have not improved it at all. An MRI just done shows a tear of the achilles tendon close to where the tendon insterts into the calcaneous (heel bone), and bone spur. After a lot of discussions with two different orthopedic doctors and my physical therapist, have gone ahead and scheduled achilles tendon surgery in 2 weeks. It's an outpatient procedure, about one hour, where they detach the tendon from the heel bone, shave off the bone spur, repair the tendon tear, and reattach it to the bone. Long recovery process ahead after surgery, it won't be much fun for at least a couple months.
Timeline: back up to last fall after I got home from a hike in Vermont, had similar symptoms, and a podiatrist gave me 2 cortisone shots in the heel, (about a month apart) and one was very close to where the MRI shows the tear. Did the cortisone shot contribute to the tear on later hikes? Not any certain answer, but I've done a lot of reading, and the evidence says cortisone shots in the heel can contribute to tearing the tendon. I knew that at the time, but wanted a "quick fix" so I could resume hiking. In retrospect, maybe it was a mistake. But the Dr said this was a degenerative problem, and the tear might have been there for some time, just become worse after the recent hikes.....
oh well, we all have much better vision in the rear view mirror
just a "Boots on the Ground" anecdote, I would tell any hikers to not get cortisone shots for achilles tendonitis. I'll share my surgery/recovery progress here as time passes. The doctor has emphasized to me to NOT rush recovery, not to put any weight on the foot for at least 2 months post-op.... I'll be using a knee scooter for at least 6-8 weeks, then crutches, then a walking boot, before PHys therapy.