My husband’s shoulder started hurting him a few months ago. At first it would come and go. Then it started aching and burning at night, so much that he couldn’t sleep on his side. I suggested lots of exercises to help strengthen his shoulder (which, to my dismay, he did not practice), and he regularly used his Yoga Tune Up® Balls for self-massage, but he was still in pain.

His shoulder pain affected me too, as he tossed and turned at night, disturbing my sleep. His pain altered our nightly sleep ritual; he had lost the ability to lie facing me, holding my hand and quietly speaking to me until we drifted into sleep. Occasionally, he would take an over-the-counter pain reliever, but they didn’t provide a cure — they only gave him a temporary “reprieve.” I urged him to see one of my favorite LA-based physical therapists, and finally he relented.

The movement Rx

Dr. Dawn at Kinesis saw the issue immediately: My husband had excessively weak external rotators (the muscles that stabilize your shoulders by keeping them “down and back,” preventing your shoulder bones from hunching up towards your ears and rolling forward toward your computer keyboard). He also had extremely tight internal rotators (the muscles that help you to hold your arms on your computer mouse and on your keyboard for hours on end). He had a classic desk jockey overuse injury, and the only remedy would be for him to take his new prescription regularly.

Dr. Dawn prescribed movement — not medicine — to remedy his pain. She also gave him a very strict dose: “Do this once for every five minutes that you work at your keyboard.” She taught him a shoulder exercise I call “The Hitchhiking Pizzas.”

Hitchhiking Pizzas

1. Stand or sit, stacking your skull over ribs and ribs over pelvis. (In other words,no slouching!)

2. Pull your arms against your sides, minimizing space between your arms and the side of your body.

3. Spin your arms so the palms face outwards, spreading your fingers as far apart as they’ll go.

4. Bend your elbows 90 degrees, as if holding heavy pizzas. Then try to move the “pizzas” backwards, imitating the action of a hitchhiker thumbing for a ride.

5. Hold for 30 seconds without letting your shoulder blades slide together. Don’t thrust your chest out and lose your stacked skull/ribs/pelvis as seen in the images below.

Movement over medicine

Within two days my husband’s shoulder pain went away. He is still doing those Hitchhiking Pizzas, although not with the frequency of the original Rx. If he doesn’t do the move several times a day (or does it wrong), the pain comes back.

Best of all, our own version of the “nightcap” has finally returned, and my husband and I can hold hands once again, dreaming soundly, profoundly and pain-free.

Conscious movement and proper positioning makes such a huge difference to the health of your body’s tissues. It amazes me that pills are constantly thought of as the “fastest way to pain relief.” In reality, it takes just a few moments to rearrange your body so that it can respond to the stresses of life instead of being broken by them. Pills take much longer to be absorbed into your bloodstream (along with their unfavorable side effects), while self-massage or a motion to reinforce a better posture take only a few moments and have no negative side effects.

I believe that self-care is the new normal for healthcare. It all starts with:

1. Being willing to improve your self-awareness.

2. Making choices that promote healing in the body.

3. Disciplined practice to reinforce health and prevent issues in your tissues.

PS. If you’d like to learn the basic moves your shoulders were designed to perform, check out this Gaiam blog.

Discover solutions for shoulder pain.

Watch our shoulder videos.

Read “Get Your Trapezius In Tune!”

Jill Miller

Jill Miller, C-IAYT, ERYT is the co-founder of Tune Up Fitness Worldwide and creator of the self-care fitness formats Yoga Tune Up® and The Roll Model® Method. With more than 30 years of study in anatomy and movement, she is a pioneer in forging relevant links between the worlds of fitness, yoga, massage, athletics and pain management. She is known as the Teacher’s Teacher and has trained thousands of movement educators, clinicians, and manual therapists to incorporate her paradigm shifting self-care fitness programming into athletic and medical facility programs internationally. She has crafted original programs for 24 Hour Fitness, Equinox, YogaWorks, and numerous professional sports teams. She and her team of 500+ trainers help you to live better in your body with an emphasis on proprioception, mobility, breath mechanics and recovery. She has presented case studies at the Fascia Research Congress and International Association of Yoga Therapy conferences. She has the rare ability to translate complex physiological and biomechanical information into accessible, relevant moves that help her students transform pain, dysfunction and injury into robust fitness. Jill is the anatomy columnist for Yoga Journal Magazine and has been featured in Shape, Men’s Journal, Good Housekeeping, Women’s Health, Yoga Journal, Self, and on the Today Show and Good Morning America. Jill is regularly featured on the Oprah Winfrey Network. She is the creator of dozens of DVD’s including Treat While You Train with Kelly Starrett DPT and is the author of the internationally bestselling book The Roll Model: A Step by Step Guide to Erase Pain, Improve Mobility and Live Better in your Body. Based in Los Angeles, CA, she is a wife and mother of two small children and is currently writing her second book.

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Duygu (Dee) Ozkan

This is one of my favorite shoulder movements. I also like to combine in standing yoga poses( like Warrior 2, Goddess pose). Imagining the air is so thick and heavy and pulling the elbows towards the ribs slowly helps to gain more awareness of the rotator cuff muscles.

Katrina LK

I love this story. Both for the sweetness of how you and your husband sleep, and also for the sheer practicality of this movement! I agree that pills are our go-to in Western society, mostly because people DON’T MOVE, EVER. If anything, pain becomes a reason to STOP moving altogether! It’s so odd to think that when we are inactive and eventually our body begins to complain, we self-prescribe further inactivity. When I’ve worked out hard and I’m sore, I feel I’ve earned that rest day. When I do nothing for a couple of days and I’m sore, the only… Read more »

Ernie M

Love this! So simple and yet effective. Will be suggesting this to all the desk jockeys I know and doing it myself right after typing this comment 🙂 Thanks!

Michelle W

What a wonderful post! I love hearing when this practice works for people experiencing real issues. It’s so true — conscious movement and proper positioning makes a huge difference in the body’s health. There are so many wonderful Tune Up moves — and so many alternatives to reaching for medication first. Thank you so much for this.

Mindy Porell

I have some slight shoulder pain in one shoulder and I plan to practice this “hitch-hiking pizza” exercise. It all begins with body awareness.

Ranghild Helmberger

Thank you for sharing. In these computer working times it is the perfect exercise. I tried it and it works!


Thank you so much for this RX!
I have shoulder pain since 3 months in the front part of the shoulder. I know that i have a protraction of the right shoulder combine with a difficulty to move my scapula.
I will definitely do this exercise every day


Great! I will try this on my husband


This was a beautiful example of taking your health into your own shoulders. How empowrring! I am going to do this every day and try to remind myself to do it throughout the day if I notice myself slouching.

Erin Hoien

Hitchhiking Pizza has become my new favorite. I’ve started my 14 year old son, already rounded from his school computer, on this exercise daily! So simple, yet complex and effective. Thank you.

Sonya Perry

This is an excellent prescription for myself! Thank you.

Miriam Rigney

Movement is medicine. It really is that simple. Thanks for posting. It’s great to have such an array of tools, poses and movements in the kit!


That is a problem that offten apears in between my clients. Pain in the shoulders, around scapula or arm. It is difficult to located and very annoing. Usually I am asking them to work with their extra rotators few times during the day. Unfortunately people are rather focused on pain and finding the solusion how to relief the pain imidiately. For that who do trust me pain usualy reliefs in a few day time with regularny practice

Kimberlee Ott

This is a regular exercise for my pilates clients for shoulder health whether using no resistance, a flex band, or on the reformer.


This article excites me so much. As a new Yoga Tune Up practitioner, I’m really excited by these various orientations to movement that never crossed my mind before. Even without shoulder pain, I’m going to practice this!

Colleen Collins

I think I am going to incorporate this one into my daily routine, I started having shoulder issues about a year ago and have tried many exercises for them but the issue has not gone away completely. This just might help. Thanks


I’m currently doing a yoga training course and with all the yoga we are doing my right shoulder (which I suffer tendonitis) on started to bother me. I tried this exercise and it helped the pain diminish. I still think I need to do it since the dull ache is still there. Thank you for the advise. Let’s hope it gets me through the training.

Esco Wilson

Nice testimonial! informative, on both a personal and practical level. Many people will be able to relate how loved ones and quality of life are negatively effected by chronic pain. Compliance wit the prophylactic regimen of daily corrective exercise is more likely when the person knows they are doing it for more then just their individual benefit. Would be nice to add any ergonomic adjustments beneficial in reducing the likelihood of re-aggravating the problem.

Beverly N.

I’m curious whether the Hitchhiking Pizzas pose is a pose orientation for Shoulder Circles where there’s retraction in the upper, middle and lower trapezius muslce?


why i have such retarded external rotators on my left side, I do not know; but I DO PREFER this to the pin the arms on the yogi variation we did in class today. I feel a lot of resistance and tightness down the whole left side of upper back, triceps area and shoulder, but not on the right! Maybe I’ll have to start the every 5 minutes practice too; because although I have not turned to pills for pain relief, I do not want to get to that point of pain at rest!

Kaiitrin Doll

I last posted on this topic about a month ago and I needed to post once again about this particular shoulder exercise. I have been doing this exercise for a month now at least three times a day and the changes I have noticed are incredible. I have had particularly bad poster most of my life and as a result have suffered from lots of shoulder pain. I have been working on my posture for the last five year and the progress has been slow until now! This exercise not only brings awareness to the external rotation of the shoulders… Read more »

Chrissy CM

Great info! I also have pain in my shoulders & at my elbows. I am hoping this will do the trick. Thanks for sharing. I’ll be sure to share with my students too 🙂

lulu yen

The part i love about yoga tune up sequences is that we are not only woking on the the target muscle but also the neighboring muscle. the simple shoulder exercise (external rotation and external rotation) will ease the neck pain. The whole body is all connected, the bone, muscle, the nerve, fascia train….. when one part of your body is comprised, the whole misaligns. crazy stuff but good stuff.


This is exactly what I needed to read today! A friend I teach with (school, not yoga), just found out I am in my second round of teacher training and looked imploringly at me saying, “PLEASE do some classes for me. I do not want to go in front of people yet, but I do NOTHING. And I need to. Mostly because my shoulders are a mess.” I promised her I would start looking into shoulder movement, ball therapy motions, poses, etc to help out, and this post is a great way to start. Texting her now to tell her… Read more »

Chantal Gray

It’s amazing that such a simple movement could make all the difference to your husband’s shoulder pain. It’s sad that we’ve become conditioned to automatically reach for medication when we have pain when often there is another option . Love that you’ve highlighted this!

Kaitrin Doll

This is fantastic, I have experienced this shoulder pain and I know many others who have as well. This is such a quick and easy exercise that anyone can do anywhere. I am going to try and do this exercise daily to see the improvements it can have on my own shoulder pain.

Alex Booth

Jill this is an awesome post. I love the entire part about movement over medicine. All those painkillers being thrown around are only temporary band-aids. I’ve been in the same position as your husband in regards to having pain issues and only being thrown pills and no proper movement routine. Thankfully people like you exist to share things such as this on the internet. I’ve self re-habbed many issues with simple diligent movement practice to correct postural and muscular imbalances which did more for me short and long term than any pain med ever would.

Donna Clark

What a fabulous and easy solution. It is something I try to do myself but was less conscious of separating external rotation from retraction. Retraction feels great and whooshes the blood in and out of those rhomboids but more pure external rotation is so much harder. I look forward to better propriocepting my own shoulders infraspinatus and teres minor and that of my seniors class. Thanks.


I absolutely appreciate this post and your other post regarding Downward Facing Dog. I have been practicing yoga almost everyday for a while and my shoulder are causing me pain. The discomfort is making me hesitate to go to some yoga classes because I am trying to avoid long down dogs or plank positions, specially side plank. I love my yoga practice of asanas but yoga has also tought me to listen to my body and be kind towards it. I love that you provide an explanation for shoulder pain. I can relate and I believe my shoulder muscles are… Read more »


My mother suffers from a very similar issue and is consistently in pain in her shoulders. Like your husband, she works a desk job where she is at a computer 8-9 hours a day. She’s tried a lot of different things to help correct the pain but nothing has seemed to help. This is definitely something I’m going to share with her and I hope it has the same effects and success on her, as it has on your husband. I appreciate the tip and the in depth description and pictures for how to precisely execute the movement; as to… Read more »

Tina Broome

Love it! Wishing more Doctors prescribed movement. FYI, Jill, I’ve been practicing Yoga for about 15 years now and since I started doing Yoga Tune Up my husband has actually started doing it too… and on his own!! Thanks for being a positive influence.


I give this exercise to probably 80% of my clients. A)they need it – most people have No connection to their infraspinatus and teres minor! B) it’s so easy for them to remember with all the fun cues! I also tell them there are slippery ipads under each armpit, so they have to squeeze firm and rotate, not swing, the humerus 😉


Seems like a very useful way to wake up the rhomboids as well as get some awareness of shoulder protraction and retraction too!


I appreciate the simplicity and accessibility of this movement and yet the absolute effectiveness. I spend a lot of time bending over students (I teach a lot of privates) giving very physical adjustments and thus have shoulders which look like I spend all day at a computer. In addition to adding into my daily shoulder maintenance routine, this is something that I can even incorporate between adjustments to take better care of myself.

Jeannette Foley

When I sought out an ART therapist to help me get relief from my shoulder issues, this was one of the first exercises he gave me. Seems many people are suffering from slumpitis and the injuries or strain it induces. In fact, the chiropractic also recommended this exercise to my son to counter his increasingly protracted shoulders. Wide application for this one.

Blake Rogers

Hitchhiking pizzas is a great exercise i’m going to use it on long drives to keep my shoulders and neck loos. Also if i cuddle with my girl wrong it will be a great way to loosen up in the am before i start my day with lots of activity. Thanks for the pictures.


I’m so glad that very specific details and illustrations for this pose are posted here. This is such an important movement, and the formula for computer use: minutes of time on exercise is a great reality check. As someone who inevitably succumbs to the lure of the bigger, more aggressive muscular actions, the last two pictures are especially relevant. I appreciate the nuance and discipline required to make the smaller, more precise and effective movements of the arm in the shoulder socket sans squeezing the shoulder blades and thrusting the ribcage forward. I now owe 2 minutes of hitchhiking pizza… Read more »


Happy to hear your back to your nightcap. The thought of the loss lit up my empathy receptors. My partner sleeps on the floor, and while I love to sleep next to him my hips often aren’t too happy about that. I prefer to sleep on my side facing him, but my hips polite request to change positions eventually becomes a blaring demand and I my change side and face away. Maybe I can find a movement Rx, or a bed, to keep my hims and my partner happy.

Caitlin Vestal

I love this post. As someone with a husband who spends all day every day hunched over his computer, it’s great to hear how simple an action helped correct what was going on in your husband’s shoulders. I will also say that although the movement itself might be a quick fix, I think the three steps you mention for self-care are actually three huge steps to take for a lot of people. Just being willing to see that our daily, habitual actions lead so directly to our physical well-being (an obvious truism for so many movement professionals) is a huge… Read more »

Strengthen Your Rhomboids To Rebalance Your Shoulders | Yoga Tune Up

[…] Tune Up® Blog « Don’t Let ‘Locked Long’ Rhomboids Drag You Down Shoulder Supplement: Daily Dose of Movement to Erase Shoulder Pain […]


This just goes to show how important both modalities are. We can’t always just roll where we think will fix a problem. Exploring the surrounding areas with mindful movement & corrective exercise must too be the balance. And when at a loss, seek assistance.


I love that this can be done anywhere, any time–even discretely while sitting at a desk! It’s so empowering to take control of the pain in our bodies without turning it over to unknown drugs that simply mask our imbalances. Thank you.

Paula B

Yay, another Yoga Tune Up pose to supplement my shoulder care classes:-) I often mention to my students how quickly we can get a prescription for pills when we consult a doctor for body aches. If anti inflammatories aren’t cutting, how about pain killers?????? Serious!! How about a little Yoga Tune Up time everyday to bring the body ( and the mind:-) back to its well deserved balance?

Geoff Brown

I believe that improving your sense of proprioception with YTU is also a way of improving your self-awareness in general. I love the idea of serving your body through a self aware and honest practice.


Love the three points of self-care especially number 3. Adherence is huge especially when it comes to counteracting and balancing repetitive movement in our daily lives. Hitchhike pizzas for every five minutes spent at the computer- talk about another level of self-awareness. Great stuff!

John Greenhow

Love this! Adding it to my daily routine of shoulder care!


Wow, this movement feels so good! I doubt that there is an American that doesn’t need this exercise. Thank you!


Wow , now I know one of the reasons I don’t sleep and my partner misses holding my hand too 🙂 Thanks Calling Pizza Pizza starting today .


Ahhh, a new one for the shoulders…Love it!

Bev Hotchkiss

Oh I like this one. My husband is a chef so he is constantly bent over the stove, over a bowl, over the counter, over the sink…you get the picture. I often think he resembles a block of stone…and although he has started doing yoga at least twice a week (Amanda Tripp is his favourite teacher). I still think that ‘hitchhiking pizza’ would do wonders for him. Then I’m thinking, this would be a great one to incorporate into a lesson plan as I think most of us have a wee bit of that internal rotation in their shoulders. Thanks… Read more »