Patients reporting presyndesmotic pain especially after fatigue and almost always after sprains with the appearance of sinu-tarsic syndrome are often encountered. Such patients are usually young and the syndesmosis may develop into a single isolated epiphenomenon of the symptoms that have preceded it. Subjective instability of the hindfoot may also occur. With all the necessary reservations it is possible to define syndesmosis syndrome as a biomechanical pathology caused by an alteration in the distal control mechanism of the syndesmosis itself in the phase when the joint is bearing weight during walking (closed kinetic chain). And it is probably the incorrect development of the subastragalar control mechanism that introduces a secondary and compensatory control mechanism in the form of altered distal tibioperoneal syndesmosis.