Anna DiMarco Physio

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Canada
Winnipeg, MB
Anna DiMarco Physio

Anna focuses on physiotherapy and the Art and Science of Living Well.

She is particularly interested in the human response to nature, the arts and beauty, and how these topics all meet at the intersection of whole person wellness ... mind, body and soul.

01/01/2026

As you welcome in the New Year….

May you land softly and gently into the hope and promise of new beginnings.

Without big expectations for “self improvement” or transformation.

Without setting forth new goals for yourself, but perhaps a few simple little intentions instead ?

Maybe it’s enough to just remember to breathe deeply and intentionally every now and then, to let your inner dialogue be as kind as your outer dialogue, to drink enough water to keep things moving well and to find a few moments of silence and/ or solitude in each day.

12/28/2025

As the year comes to a close, I like to review some of the quotes that speak to me loudly in this particular moment of my life.

I am sharing a little assortment of those quotes here, plastered on some of my favorite captures of Mother Nature doing her magnificent thing.

My themes seem to be centred around the generosity of attention, the power of presence, the healing power of self awareness/ self knowledge and self compassion/ kindness, and the human need for some form of creative expression.

What will you focus on as we move out of 2025 and into 2026 ?

12/22/2025

Thanks for this one doctor Michael .

I decided it deserved a permanent spot here on the grid .

12/13/2025

It may be -32 with that windchill with a yellow flag warning for the cold , but it's a dry cold 🤣

And we get these gorgeous sun dogs !

12/04/2025

Bridging the Gap in Osteoporosis Care

While Manitoba and many other provinces do not yet have a FRACTURE LIASON SERVICE, we can still close the gap (or at least improve upon it significantly) with public awareness, professional education and improved communication between healthcare providers.

Physiotherapists are in a unique position to offer very valuable input through their ability to clinically screen patients they come into contact with, regardless of the initial entrance complaint. We can identify who is at risk by taking a thorough subjective history (see previous post re risk factors) and by working through a holistic lens as we assess posture and movement strategies (see previous post re screening without BMD) ….something we are doing at all times anyway.

By thinking more holistically, we can identify risk factors and physical signs that indicate further investigation is warranted. We can even screen via FRAX or CAROC without any BMD results and see where the client lands in terms of risk of a future fracture. (Link in bio for these two screens).

We can then direct them to their primary care physician for BMD testing and other clinically relevant screening.

And, even though insurance providers do not “fund” prevention, despite the endless ad campaigns suggesting they do, we can utilize our time with patients (while addressing their initial entrance complaint) to educate them about potential future risks of pathological bone loss and how to minimize that potential through appropriate lifestyle choices, nutrition and movement strategies.

If the client’s initial entrance complaint is for osteoporosis (with or without history of a fragility fracture), it is imperative that we meet the client where they are with their situation. Many will be very distressed about the diagnosis, the pharmacological intervention, the future, etc. Do find a way to empower them with up-to-date information, but ensure you understand their true risk of future fracture. Informed optimism.

Osteoporosis care…We can do better and we must do better.

12/02/2025

The Osteoporosis Care Gap
There is a worldwide and national gap between clinical practice guidelines and real world application of same.

Fewer than 20% of Canadians who sustain an osteoporosis-related fracture receive appropriate medical management within one year of the fracture.

Unfortunately, this gap in care can lead to further fractures impacting quality of life, and to an increased financial load on both the patient and the healthcare systems.

Poor screening occurs due to a complex interplay of patient-related issues and provider and systemic related issues. As well, relying solely on BMD scores to initiate care can lead to delayed treatment. Furthermore, according to the International Osteoporosis Foundation’s position paper (September 9, 2025) there remains some professional confusion surrounding diagnostic and intervention thresholds.

The Fracture Liaison System is a worldwide system created to address the gap between clinical practice guidelines and actual care being delivered. There are a limited number of provinces who have implemented the FLS model. Manitoba is not one of them.

It is proposed that utilizing the FLS can improve long term clinical outcomes AND reduce osteoporosis related healthcare costs (4.6 Billion dollars annually in Canada).

Unfortunately, we have come to accept osteoporosis as a normal process of aging, and it is not prioritized as a disease of concern in most provinces despite it’s heavy cost in quality of life and in healthcare spending.

There is some hope…researchers in Denmark have recently released a study demonstrating that the osteoporosis is as costly to society as cancer. Hopefully, we will come to embrace effective strategies to ensure prevention, early detection, appropriate screening and implementation of effective management strategies to offset these high costs.And more importantly, to improve patient outcomes.

We can do better. We MUST do better.

11/30/2025

Nutrition is a key component of Osteoporosis Prevention and Management

Nutrition plays an important role in bone health throughout our lifespan…assisting with the foundation of peak bone mass in early adulthood and modifying the rate of bone loss as you age.

Bones are dynamic living tissue that constantly renews and repairs itself. And like other parts of your body, bones require a wide array of nutrients for proper development, maintenance and function.

Furthermore, if you have been diagnosed with Osteoporosis and are using a pharmacological agent to improve bone density, it is critical that you are getting adequate nutritional support for your bones.

In some cases, you may require supplementation to meet the recommended dietary allowance (RDA).

Be sure to always discuss supplementation with your primary care physician or the specialist managing your osteoporosis.

Let’s test your knowledge and maybe have you learn something new as you swipe through the carousel of slides.

strongbones
foodismedicine
nutritionalresearch
boneislivingtissue

11/28/2025

Osteoporosis: Safe and Effective Exercise Prescription

LIFTMOR study….Lifting Intervention for Training Muscle and Osteoporosis Rehab

In 2018, Australian researchers challenged conventional wisdom and undertook an 8 month study utilizing high intensity strength training and high impact jumping with post menopausal women who were diagnosed with osteoporosis. Participants gained significant increases in BMD in the hip and low back regions.

Prior to this study, researchers and rehab practitioners were rightfully hesitant to prescribe either high intensity strength training or high impact jumping for this demographic due to the potential risk of vertebral fracture.

The impressive results from the LIFTMOR study (and the LIFTMOR-M STUDY, 2021, looking at men with low bone mineral density and the same protocol) have transformed how many of us working with this population, either in physical rehabilitation or in the strength and wellness realm, address exercise prescriptions for this group. We are eager to adopt the protocol and empower our patients/clients to “lift more” and “jump” for improved bone density.

However, we should keep in mind these three critical features of the study: Participant Selection, Participant Preparation and Participant Supervision. When the LIFTMORE protocol is applied without appropriate selection, preparation and supervision, there have been several reports of adverse events, including vertebral fractures.

Furthermore, as healthcare providers or fitness coaches working with this population, it is important to consider that the ultimate goal of osteoporosis management is fracture prevention, not just increased bone density. And fracture prevention requires fall prevention training, functional training and education re safe movement and spine sparing movement.

Beyond “lifting more” those who are exercising with low BMD require a safe and sustainable plan and should be guided by a health care professional who can assess, modify and progress a CUSTOMIZED program safely.

Scroll through the slides for more info before you simply “lift more!”.

11/26/2025

Healing Journey

Seeing my 85 year old client exceed her own expectations recently brought me immeasurable joy, inspiration and a deep sense of connection and fulfillment .

Towards the end of our session, she excitedly said to me “oh, watch this!” as she quickly clambered up onto the treatment bed and sat fully cross legged on it….following two knee replacements and one hip replacement over the course of 2.5 years! (We first met while “prehabbing” a shoulder replacement approximately 8 years ago).

Not only has she gained increased physical capacity through her physical rehab journey, she has been transformed by the process into a stronger, more confident version of herself. She fully embraced prefab and rehab, committing to the process whole-heartedly. And in the end, she found a new version of herself, one who at 85 years old is joining a gym this month for the first time in her adult life.

Her transformation and the whole journey between the first time we met and today has been a healing journey for us both . There is no question I have drawn strength and hope and met some of my own fears and insecurities right alongside her.

When we approach medicine and physical therapy as a “service to the wholeness in eachother and the wholeness in life”, we recognize that the nature of life is indeed sacred and that we are welcomed into eachother’s lives to enter into a mutually renewing process.

When we see everyone as “whole” (vs requiring “fixing”), not only are we empowering one another to accept our wounds and limitations, we are also fostering a sense of connection (I see you. I am you in many ways. We are in this together.) rather than a sense of judgement that has a tendency to separate us.

I am ALWAYS most aware of the mutual benefits of this healing relationship when my own heart is hurting because of my own struggles with life’s circumstances. I am healed in some small or big way every day that I am gifted the opportunity to work with my clients. I am grateful that they made their way into my life and into my heart.

connection
inservicetolife
physiotherapy
physicaltherapy
loveismedicine

$Screening for signs of vertebral fractures :We can indeed screen for signs of vertebral fractures using a thorough subje...$

11/25/2025

Screening for signs of vertebral fractures :

We can indeed screen for signs of vertebral fractures using a thorough subjective history and a few simple objective measurements.

If the subjective history includes risk factors for osteoporosis (see previous post) AND/OR the patient (or you) exhibit signs of potential vertebral fracture(s) via :

loss of height greater than 2cm ( 3/4 “) or 6cm (2.5”) since being a young adult

reduced distance between the pelvis and rib cage ( less than 2 finger breadths).

or has a large occipit-to-wall distance (OWD TEST or FLESCHE TEST) of 5cm or more (approx 2 inches)

Further investigation via imaging is recommended.

osteoporosis
osteoporosisscreening
gapincare
physiotherapy
physicaltherapy

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Winnipeg, MB
R3P0N5

Website

http://www.tuxedophysiotherapy.com/

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Tuxedo Physiotherapy

Tuxedo Physiotherapy (formerly Anna DiMarco Physical Therapy) has been providing quality care since 2003. We are a physiotherapist-owned and managed rehabilitation clinic located in the heart of Tuxedo. We offer orthopaedic/musculoskeletal physiotherapy, acupuncture treatment for pain, occupational therapy and massage therapy.

We will conduct a thorough assessment of your particular situation and provide you with a customized treatment plan to address your personal needs. We are dedicated professionals with a firm commitment towards listening with empathy, acting with integrity and providing quality care. We will provide effective, evidence-based services in a comfortable environment and empower you with the knowledge to live well and stay strong.