My general opinion is that frame geometry has become too steep across all sizes. Compound this with the rider sitting even steeper to solve a 'reach' issue = hand pressure, saddle pressure, etc.
Feel free to pm me your measurements, but let me guess where you are right now:
your saddle 'setback' from the bottom bracket is about 4cm (distance to nose of saddle from vertical line bisecting bottom bracket)
You are on 172.5 cranks. Your saddle height is +/-680mm
You have a short/wide saddle with a cutout, yet try to sit as far back as possible on the saddle?
FIST/SICI/FIST DOWN DEEP