Breaking the Silence: Understanding and Treating Urinary Incontinence

Urinary incontinence is one of those topics many people quietly deal with—but rarely talk about. We learned more in a recent conversation with pelvic health specialists, Kelsey Wiskow, DPT, and Jennifer Thalmann, DPT, physical therapists at Perham Health’s Nelson Therapy Center. As we talked, one theme kept coming up: this condition is far more common than people realize, and just as importantly, it’s highly treatable.

Understanding Bladder Leakage

“It’s probably more common than you think,” Thalmann explained. “Most people don’t feel comfortable talking about it, so the numbers we see are actually underestimated.” While estimates suggest about 1 in 5 individuals of the general population experiences urinary incontinence, that number rises significantly when you take a closer look—especially among women—and continues to increase with age.

Despite how common it is, urinary incontinence is often misunderstood. Many people assume it’s simply part of getting older or something they just have to live with after having children or surgery. But clinicians are quick to push back on that idea.

“It’s very common—but that doesn’t mean it’s normal,” Wiskow emphasized. “Our bodies aren’t designed to leak fluid. If it’s happening, it’s a sign something isn’t working correctly.”

That “something” can vary. Some people experience leakage when they cough, laugh, exercise, or lift something heavy—a condition known as stress incontinence. Others feel a sudden, overwhelming urge to use the bathroom and can’t make it in time. Many deal with a combination of both. Regardless of the type, all forms can disrupt daily life in ways that go far beyond inconvenience.

For many patients, incontinence becomes something that quietly controls their routine. They plan their day around bathroom access, avoid certain drinks, or feel anxious about leaving the house. “It starts driving their life,” Thalmann shared. “They’re always thinking about where the nearest bathroom is or whether they might have an accident. Our goal is to take that burden away.”

This is where pelvic health physical therapy can make a significant difference. Treatment doesn’t start with complicated equipment or invasive procedures. Instead, it begins with conversation, education, and a deeper understanding of how the body functions.

Physical Therapy Can Help

Jennifer Thalmann, DPT, and Kelsey Wiskow, DPT, physical therapists at Perham Health.

During an initial appointment, therapists explore habits, patterns, and daily routines—everything from fluid intake to how often someone uses the bathroom. Patients are often surprised by how much these small behaviors matter. “Education is one of the biggest pieces,” Wiskow said. “A lot of people don’t even know what the pelvic floor is or how it works until we sit down and explain it.”

There’s also a common misconception that treatment is all about doing Kegels. While those exercises can play a role, they’re far from the full picture. In fact, some patients discover their issue isn’t weakness at all—it’s tension.

“We see a lot of people who think they’re weak, but their pelvic floor is actually too tight,” Thalmann noted. “They can’t relax those muscles, and that can cause leaking too.” In those cases, therapy focuses more on coordination, breathing, and learning how to properly release tension rather than strengthening.

Another key takeaway is how much progress depends on what happens outside the clinic. Visits are typically once a week, but most improvement comes from consistent practice at home—adjusting habits, following exercises, and paying attention to patterns. While that might sound like a commitment, results often come sooner than expected.

“Most people start seeing some kind of change within about a month,” Wiskow said. “Sometimes even sooner.”

The Good News About an Awkward Topic

Still, many people wait years before seeking help. The reason isn’t a lack of options—it’s discomfort with the topic itself. “Embarrassment is probably the biggest barrier,” Thalmann explained. “People feel like they’re the only ones going through it, or they think it’s just something they have to accept.”

That silence can be especially pronounced among men, who often hesitate even longer to bring up symptoms, despite experiencing them at significant rates, particularly after procedures like prostate surgery. But across all groups, the message from providers is the same: no one should feel alone in this.

“We treat this every day,” Thalmann said. “And we’ve seen how much it can improve. People don’t have to live like this.”

Even individuals who have dealt with symptoms for decades can benefit. While early treatment is ideal, it’s never too late to see improvement. And therapy isn’t limited to adults—it can also help children who experience bladder issues, often linked to underlying factors like constipation or coordination challenges.

Ultimately, the biggest misconception about urinary incontinence isn’t just what causes it—it’s the belief that nothing can be done. “It’s treatable, and we’re here to help,” Wiskow said. “That’s what I wish more people knew.” For those quietly managing symptoms, that message alone can be powerful: you’re not alone, and you don’t have to keep living this way.

If you’re experiencing symptoms of incontinence, you don’t have to navigate it alone. The team at Nelson Therapy Center is here to help you find relief in a supportive, private, and compassionate setting. You can call today to schedule an appointment with Kelsey Wiskow, DPT or Jennifer Thalmann, DPT, both of whom are dedicated to providing personalized care that prioritizes your comfort and dignity. Take the first step toward feeling more confident and in control—help is just a phone call away.