Here's my set up. I ride a 56cm Surly Cross Check. It's little long in the top tube but I switched out the stock stem (100mm 97 degree) for a 90mm stem with a 117 degree rise. The 90mm stem effectively shortened the reach from the saddle to to the handlebars, similar to a smaller 54cm Cross Check. The handlebars are pretty high up already, almost level with the saddle. Perhaps 1cm lower. The stand over is fine, even with fattish tires. All good, right?
Here's my problem. I can't ride anything but the the tops for very long. The drops and hoods are pretty uncomfortable, so my default position for 90% of my riding is on the tops. I even installed interrupter brake levers to have easier access to the brakes. According to Lovely Bicycle blog's guide to drop handlebar positions, the tops should be the least used position, but it's just about the only position I use, so something is not right. Some people say HTFU. Some people say I need thicker bar tape or bar pillows. Some people say I need thinner gloves with less padding or gel gloves with more padding. However, I think these are all smaller band-aids on a larger problem. My handlebars have never been comfortable in the 3 years I've owned my bike and I've tried many adjustments. I'm thinking about buying a compact bar with a shallow drop and a flat ramp up to the hoods. I'd really love to optimize the randonneuring and touring capabilities of this bike since my flat bar fixie takes care of all my in town needs.
[FWIW, my handle bars are Salsa Moto Ace Bell Laps. (144mm drop, 82mm reach, 44cm width)Their intended purpose is "cyclocross." Perhaps that's part of the problem. Cyclocross races require aggressive riding for no more than an hour, right?]
Maybe it's not completely necessary to buy a new compact handlebar. Is there any adjustment I haven't thought of yet that I can try to relieve pressure on my hands?? My knee caps are directly over the pedal axles, so I can move it forward a bit. I adjusted the fore/aft position using Jim Langley's online guide to bike fitting, but it's only a guide line.