hi, thank you for providing the brief history of you. A thorough musculoskeletal assessment is advised. Based on your history, X-ray was normal and MRI was showing tear of the tendon. Well, X-ray cannot show soft tissues and it is taken only for bony deformity, so in any case x-ray will be normal. Also, if MRI shows the tear of the tendon, than what is the grade of the tear? As based on the grade of the injury, the conservative or surgical treatment is planned. If there is complete tear than surgery is advised but if it is partial or fibers of tendon tears , then conservative treatment is planned. Usually in my clinical practice, i have seen patients recovering in the conservative treatment and never need surgery. Also, you can try performing physical therapy as it will help you reduce the inflammation by using therapeutic ultrasound therapy and for pain relief, TENS therapy. Later stages, exercises will be performed and taught as well, to regain the Elbow complete ROM and Strength in the muscles so as to avoid direct strain on the tendon. Which means, your case will be treated on a special note like a sports injury case to regain the maximum output of the upper limb functions without straining or damaging further the tendon. My clinical practice have only advised for conservative therapy than surgical one. Regards Jay Indravadan Patel