...I'll ignore that, but it did pull up a genuine thought.
I know you've been a bit resistant to ebikes (though not completely long-term) but I do genuinely wonder whether one would provide a good rehabilitation path for you.
The assistance means that you have to put less effort in than you might, and that means less stress on the arms.
It might provide a way forward (either interim until you recover or longer term if you don't). It would possibly be a way to continue doing what you enjoy at a more early rate.
One of the issues, of course, is that you get used to it (though it brought a smile to my face for 1 and 1/2 evenings).
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