Jay Eckardt on The Hidden Accessibility Problem in Modern Wellness
More than 1.3 billion people worldwide live with a significant disability, according to the World Health Organization, representing roughly 16% of the global population. The figure makes one assumption embedded in mainstream wellness increasingly difficult to defend: that the body participating in wellness looks, moves, breathes, and processes information in a predictable way.
The stakes extend well beyond yoga studios and meditation apps. WHO data shows that people with disabilities face substantially higher health risks and persistent barriers to care. In 2025, the organization launched a global initiative focused specifically on advancing health equity for people with disabilities, underscoring how deeply accessibility remains tied to health outcomes.
Yet wellness advice often arrives packaged as though its foundational practices require little examination: slow the breath, sit in a particular position, visualize a calmer future, practise gratitude. The instructions may appear benign, but each carries an implicit expectation about physical capacity, sensory tolerance, attention and control. For people whose bodies do not accommodate those assumptions, the exercise can become another source of friction.
The distinction matters because accessibility is not simply a question of making an established practice easier to perform. Jay Eckardt argues that the deeper issue lies in deciding who gets considered at the point of design. “If you build a building with stairs and add the ramp later, that building is only accessible in retrospect,” Jay explains. “If you build a ramp first, it’s immediately accessible to the entire community.”
Jay, Founder and Lead Health & Empowerment Coach at Problematic Pineapple LLC, has built their approach to mindfulness around that premise. Their work focuses on creating practical, trauma-aware tools for disabled, chronically ill, and neurodivergent communities, with the broader proposition that accessible wellness should begin with practices capable of meeting different physical and cognitive realities. Their book, No Breathwork, No Bullsh*t, puts that argument directly into practice by questioning the assumption that breathwork and movement must sit at the center of mindfulness.
Jay’s own experience made the gap difficult to ignore. Living with Muscular Dystrophy and using a ventilator meant they could not intentionally control their breathing in the way conventional breathwork exercises often require. During their coaching training, repeated instructions to slow or regulate the breath did not provide the grounding such practices were intended to offer. They triggered anxiety instead.
“At first, I felt like I was doing something wrong,” Jay recalls. “I had to figure this out, because this is literally the foundation of a lot of my practices.” The realization eventually shifted the question from how to make their body conform to the exercise to what the exercise was actually trying to accomplish. Centering attention in the present, calming the nervous system, and reconnecting with the body could still be pursued through different means.
Jay argues that the same scrutiny should extend to visualization, static positioning, and other practices often treated as foundational. A pose may be physically impossible, visualization may heighten distress, or a breathing exercise may be incompatible with someone’s respiratory reality. In each case, Jay believes practitioners should examine the tool before assigning the difficulty to the person using it.
The argument becomes particularly important around stress. Jay points out that wellness language often frames stress as a temporary condition that can eventually be resolved. For people living with complex medical needs, dependence on care, inaccessible services, or recurring medical trauma, some sources of stress are embedded in daily life. The useful question, in Jay’s view, is therefore how wellness can create relief during an ongoing reality rather than promising to eliminate it.
This approach changes how alternatives are selected and shifts the focus back onto the intended response behind the practice. Jay often introduces sound-based practices because they can provide an avenue into mindfulness without requiring intentional engagement, such as deliberate breath control or sustained physical positioning.
Gratitude also requires more care. Instead of insisting that someone practice performative positivity, Jay argues that a practice should leave room for anger, frustration, or exhaustion before asking a person to find something worth appreciating.
“If you need to be angry, be angry,” Jay explains. “If you are so frustrated and so shut down in the moment, let’s fully acknowledge that and give it the space that it deserves.”
The broader challenge is therefore architectural. Wellness, Jay posits, cannot meaningfully call itself inclusive while its foundational assumptions continue to be built around a universal body. Jay’s “ramp first” philosophy offers a more exacting standard that accessibility belongs at the beginning of the design process, where practices are chosen with different capacities in mind and adapted as people’s circumstances change.
A wellness practice that fails someone should prompt a different question. Instead of asking why the person could not make the practice work, Jay’s framework asks whether the practice was ever designed to work for them in the first place. That shift places responsibility on the practitioners and wellness industry as a whole. Practice recommendations and wellness tool design should be called into question long before another person is asked to squeeze themselves into a system that was never built with their reality in mind.
This article is for informational purposes only and does not substitute for professional medical advice. If you are seeking medical advice, diagnosis or treatment, please consult a medical professional or healthcare provider.
