When you have been dealing with chronic pain for long enough, especially something as complicated as TMJ dysfunction, you quickly learn that finding a provider who actually looks at the entire picture can be surprisingly difficult. Over the past year, I have seen more than a dozen healthcare providers trying to figure out the source of my jaw, ear, head, and neck pain. That list has included chiropractors,
massage therapists, other physical therapists, an oral surgeon, and three different dentists. I have had imaging, manual treatments, adjustments, exercises, dry needling, and three different mouth guards or splints. Many of those providers helped with individual pieces of the problem, but I continued to deal with the same underlying dysfunction and recurring symptoms.
My TMJ Story
My TMJ problems started after my jaw displaced approximately a year ago. What initially seemed like an isolated jaw problem gradually became much more complicated. I continued to have compression and tracking issues along with abnormal movement of the jaw, but over time I also developed significant muscular tension and overactivity, motor-control problems, reduced muscular endurance, and neck and postural issues. The symptoms eventually spread well beyond the jaw itself and included temple pain, headaches, suboccipital pain at the base of my skull, significant SCM and upper-trapezius tension, and probably the most frustrating symptom of all—a persistent deep ear pain that at times has been enough to drive me crazy.
One of the biggest things I have learned throughout this process is that TMJ dysfunction isn't necessarily just a jaw problem. The jaw does not function independently from everything around it. The cervical spine, posture, muscles of the face and neck, strength, endurance, movement patterns, and motor control can all become part of the equation. In my case, after dealing with the problem for approximately a year, it became increasingly apparent that simply addressing the position of my jaw or temporarily loosening tight muscles was not enough. There were movement and muscular patterns that had developed over many months, and those patterns were not going to disappear overnight.
That is also why I want to be realistic about my experience and recovery. This is a process. I have dealt with dysfunctional movement, muscle guarding, overactivity, weakness, endurance deficits, and pain for roughly a year. My body has had a long time to develop and reinforce some of these compensations, so I don't expect one treatment, one exercise, or even a handful of appointments to completely undo them. It is going to take time to retrain movement, build strength and endurance, decrease unnecessary muscle activity, and allow an irritated system to gradually settle down. What is encouraging to me is that, after a year of searching for answers and trying different approaches, this is the first time I feel like I am seeing real progress rather than simply chasing temporary relief.
A Thorough Evaluation That Looks for the "Why"
One of the things that impressed me most about Dr. Pino was how much time he spent evaluating the possible causes of my symptoms rather than immediately treating the area that hurt. With something as complicated as TMJ dysfunction, simply knowing that the patient has jaw pain or deep ear pain doesn't necessarily tell you why that pain is occurring. He looked at whether the symptoms could be coming primarily from the jaw itself, whether the cervical spine could be contributing, whether there were strength or muscular-endurance deficits, whether certain muscles were overworking to compensate for others, and whether the underlying problem involved mobility, motor control, movement coordination, or some combination of those factors.
He also paid close attention to how my jaw actually opened and tracked rather than simply measuring whether I could open it. That distinction has been important for me. Being able to perform a movement does not necessarily mean that you are performing that movement well. If the jaw is getting from point A to point B by compensating, shifting, or over-recruiting certain muscles, simply practicing more opening may reinforce the same dysfunctional pattern. His approach has involved trying to understand what my body is doing during those movements and then finding ways to gradually normalize them.
As someone who works in healthcare, I really appreciate that type of clinical reasoning. I don't want a provider to simply find something that hurts and repeatedly treat that spot. I want someone asking why it hurts, what structures could be contributing, what is maintaining the problem, and what needs to change for the improvement to actually last. That has been one of the biggest differences I have noticed at True Function Physical Therapy.
A Multifaceted Approach Instead of Relying on One Treatment
Another thing I appreciate about Dr. Pino's approach is that he doesn't seem committed to making every problem fit one particular treatment. That became increasingly important to me after seeing so many different providers. If you go somewhere where the primary tool is a chiropractic adjustment, treatment naturally tends to revolve around adjustments. If the primary tool is massage, the focus tends to be on releasing tight muscles. If you see a dentist for TMJ problems, treatment may primarily revolve around changing the position or loading of the jaw through a mouth guard or splint. Those treatments can absolutely have value, and I have benefited from pieces of several of them, but my experience has shown me that a complicated problem isn't always going to be solved by one intervention.
My treatment at True Function has been much more multifaceted. Dr. Pino has used the information from the evaluation to combine hands-on treatment, dry needling, movement retraining, strengthening, motor-control work, postural considerations, patient education, and specific home exercises into a larger plan. Instead of viewing any one of those things as "the fix," they become tools that can be used at different points in the recovery process depending on what my body needs.
Dry needling has been particularly useful for me because some of the muscles around my jaw and neck have become extremely tight and overactive. At times, the dry needling almost feels like it helps reset those muscles and calm the system enough to give me a few days of noticeable relief. After dealing with persistent deep ear pain, headaches, and neck tension, even that temporary reduction in symptoms can be extremely valuable. The difference is that the treatment doesn't end there. We then use that window of reduced tension to work on movement quality, jaw opening, muscular control, posture, strength, and endurance so that hopefully my body becomes less dependent on those compensatory patterns over time.
That makes much more sense to me than repeatedly loosening the same tight muscle without asking why it keeps becoming tight in the first place. A muscle may be overactive because it is compensating for weakness somewhere else, because the movement pattern is inefficient, because another structure isn't moving appropriately, or because the nervous system has spent months guarding an area that it perceives as painful or unstable. If you only treat the tension without addressing the reason it continues to develop, it makes sense that the relief may not last.
Movement Retraining and Feedback
Another part of the treatment that has been especially valuable is the amount of guided movement feedback I receive. TMJ exercises can look incredibly simple from the outside, but the movements involved are small enough that subtle compensations matter. You can technically perform an exercise correctly on paper while still recruiting the wrong muscles or allowing the jaw to track incorrectly.
Dr. Pino watches how I actually perform the movements and provides feedback on what needs to change. We have worked on opening mechanics, tracking, muscular control, cervical positioning, posture, and exercises intended to improve the strength and endurance of the supporting musculature. That has helped me understand not only which exercises to perform but also what the movement is supposed to feel like and what I am actually trying to accomplish.
The home exercise component is another part of the process that I appreciate. The goal isn't for me to become dependent on someone repeatedly working on my jaw or neck every week. The hands-on treatments can help decrease symptoms and create an opportunity for better movement, but ultimately I need to develop the strength, endurance, coordination, and movement quality necessary to maintain those changes myself.
Education Is a Major Part of the Experience
Another reason I have been impressed with True Function is the amount of education Dr. Pino provides, both during appointments and through the educational content he makes available outside the clinic. He doesn't simply perform a treatment and send you home without explaining what he is seeing or why he is doing something. He takes the time to explain what may be contributing to the symptoms, what we are trying to change, and why a particular exercise or treatment fits into the overall plan.
He also puts out a significant amount of free educational content and videos covering TMJ dysfunction, movement, rehabilitation, and related issues. I think that says a lot about a provider. There is obviously a business component to any healthcare practice, but there is also a genuine effort here to educate people and give them useful information even before they ever become a patient.
That education has been especially valuable with a problem like mine because chronic pain can become incredibly frustrating when you don't understand what is happening. When symptoms fluctuate, it is easy to assume something new is damaged or that you're suddenly back at square one. Understanding the roles of muscle tension, motor control, fatigue, movement patterns, posture, loading, and the cervical spine gives you a much better framework for interpreting what your body is doing and understanding why recovery may not always be perfectly linear.
Friendly, Caring, Thorough, and Individualized
Some days the jaw itself may feel relatively good while the deep ear discomfort, suboccipital tension, or SCM and upper-trapezius symptoms are more noticeable. Other times the tracking or muscular control of the jaw becomes the bigger issue. Instead of assuming every appointment should look exactly the same, he evaluates what is happening and uses that information to determine what makes sense to work on that day while still keeping the long-term plan in mind.
I'm Driving More Than 1.5 Hours for Treatment—and It Has Been Worth It
Probably one of the strongest endorsements I can give True Function Physical Therapy is simply the amount of effort I am willing to put into getting there. I drive more than an hour and a half each way for my appointments. Between work, family, training, and everything else that goes into a normal week, that is not an insignificant commitment. I would not continue making that drive if I didn't believe I was getting something substantially different from the treatment.
After spending the better part of a year going from provider to provider looking for answers, it has been worth every bit of that time to work with someone who is willing to evaluate the entire system and methodically work through the different contributors to my symptoms. I don't expect him—or anyone else—to magically undo a year of dysfunction in a few appointments. What I wanted was someone who could help me understand what was happening, develop a logical plan, reassess that plan as things changed, and give me the tools to gradually work my way back toward normal function. That is what I feel like I am finally getting.
Progress, Not an Overnight Fix
I think this is an important point for anyone reading this review because I don't want to portray chronic TMJ rehabilitation as something that is fixed instantly. I am still in the process of working through this. After roughly a year of dysfunction, my muscles, movement patterns, strength, endurance, and motor control are not going to normalize overnight. There are patterns that my body has repeated thousands of times over the past year, and changing those patterns takes repetition and time.
Recovery also isn't necessarily linear. There can still be good days and bad days. A treatment may dramatically calm things down for several days, and then some tension may return. An exercise may initially be difficult and gradually become easier as the correct muscles become stronger and more coordinated. Symptoms can fluctuate while the underlying function is still improving. That doesn't necessarily mean the process isn't working.
For me, the biggest difference is the overall direction. After trying so many different things over the past year, this is the first time I feel like I am making real, measurable progress instead of simply bouncing between temporary treatments. My jaw movement and tracking have improved, I have a better understanding of what is contributing to my symptoms, and I finally feel like there is a structured plan aimed at restoring function rather than simply managing pain.
I still have work to do, and I expect that work to take time. In some ways, I actually find that reassuring because the treatment plan matches the reality of the problem. If dysfunction has developed and been reinforced for a year, it is reasonable to expect that rebuilding normal movement, strength, endurance, and muscular coordination will take consistency. I would much rather have a provider give me a realistic path forward than promise an overnight solution.
Why True Function Has Been Different for Me
My biggest takeaway from my experience with True Function Physical Therapy is that complicated problems often require more than one solution. A mouth guard may change how the jaw is loaded, but it doesn't necessarily retrain poor movement. Massage can decrease muscular tension, but it may not address why those muscles repeatedly become overactive. An adjustment may temporarily change mobility, but mobility alone may not correct a strength or motor-control deficit. Dry needling can calm an irritated or overactive muscle, but without movement retraining and strengthening, the same pattern may eventually return. Exercises are important, but those exercises also need to be appropriate for the actual dysfunction and performed correctly.
What I appreciate about Dr. Pino is his willingness to put those pieces together rather than trying to make my symptoms fit one particular treatment method. Instead of simply asking, "What treatment do we use for TMJ?" the approach feels much more like, "What is contributing to this person's symptoms, and what combination of treatments gives us the best chance of changing those factors?"
That difference has been huge for me.
My Recommendation
If you're dealing with persistent TMJ pain, jaw clicking or tracking problems, headaches, facial pain, deep ear pain, neck tension, difficulty opening your mouth, or a combination of symptoms that nobody seems to be able to put together, I think True Function Physical Therapy and Dr. Tyler Pino are absolutely worth considering, particularly if you have already tried other treatments without getting the results you expected.
This isn't a testimonial about walking into one appointment with a year-long problem and walking out completely cured. I am still working through my recovery, and there have been ups and downs along the way. Instead, this is a testimonial about finally finding a provider who is willing to look at the whole problem, explain what he is seeing, and systematically work through the different pieces with me.
After more than a dozen providers, multiple treatment approaches, and three different dental appliances, this is the first time during this entire process that I genuinely feel like I am making meaningful progress toward normal function. That doesn't mean every symptom has disappeared or that there won't be more work ahead. It means I can finally see improvements in the things that matter—movement, tracking, control, understanding what my body is doing, and having an actual plan for addressing the factors that have kept the problem going.
Dr. Tyler Pino combines a thorough evaluation with hands-on treatment, dry needling when appropriate, movement retraining, strengthening, motor-control work, education, and individualized home exercises. More importantly, he uses those tools as parts of a larger plan rather than treating any one of them as the entire solution.
For me, that is what good physical therapy should look like. The goal shouldn't simply be to make you feel better for a few hours after an appointment. It should be to understand the dysfunction, reduce the symptoms, restore normal movement and capacity, build the strength and control needed to maintain those improvements, and ultimately help you get back to your normal life without constantly having to think about the problem.
How to Find True Function Physical Therapy
If you're interested in learning more about Dr. Tyler Pino's approach or want to see whether TMJ-focused physical therapy might be appropriate for you, True Function Physical Therapy is located in Franklin, Tennessee, and serves patients throughout Franklin, Brentwood, Nashville, and the surrounding Middle Tennessee area. The practice specializes in TMJ dysfunction and jaw-related pain, including symptoms such as jaw pain and soreness, clicking or popping, headaches, ear pain, neck tension, difficulty opening the mouth, and pain with chewing.
True Function Physical Therapy
Dr. Tyler Pino, PT, DPT
6200 Hospitality Drive, Suite 108
Franklin, TN 37067
Call or Text: 615-882-4882
True Function also offers a free 10-minute TMJ consultation, which can be a good starting point if you aren't sure whether physical therapy is appropriate for what you're experiencing. According to the practice, you do not need a referral to schedule an evaluation. They also offer mobile concierge physical therapy services in Franklin and the greater Nashville area.
I would also highly recommend checking out True Function's website and educational content even if you aren't ready to schedule an appointment. Dr. Pino puts out a lot of free information explaining TMJ dysfunction, jaw and neck mechanics, common symptoms, rehabilitation, and things patients can begin thinking about when trying to understand why their symptoms keep returning.
Website: True Function Physical Therapy — truefunctionphysicaltherapy.com
You can also look for True Function Physical Therapy / Dr. Tyler Pino on social media for additional educational videos and TMJ-related content.
