I have a very similar issue, whenever my estrogen is like 1-17 pg/ml , my left shoulder tendonitis flares up, or bicep tendon that goes down from the shoulder, whatever,
that's my tell tale sign. This just happened to me recently, I stopped adex for 1 week, put it back in at half the dose, and 2 weeks later i just had a shoulder workout and It feels 80%.
For me, I'm going to increase my testosterone dose, TO my A.I dose, its easier to dial in estrogen that way.
(this might mean you have to run more testosterone if you're on a cruise)
I'm also going to be running BPC 157/TB-500 preventatively and to strengthen everything up as I continue to recover. (my e2 was probably on the too low end for 1-2 months). (I would run HGH like everyone else but its not my look)
As others have said, and if you dont care about hairloss or anything, try using Masteron for its potential SERM like effects.
i wouldn't recommend nolvadex long-term for people because it does increase blood clotting risk and has a long half life that builds up in the system, just something to think about.