I sent an email to ISM with a reference to this thread, and here is the response I got:
Hi Al,
Thanks for being an ISM saddle rider and writing about it!! A link was forwarded to me along with your email. First, I like to call the break in period a 5 ride test. By the 5[SUP]th[/SUP] ride you are more comfortable and adapted to the saddle than on the first or second ride. The reason for this and from reading some of what you wrote you feel the bone structure supporting your weight in a way you did not before. This is a good thing! The ISM design eliminates pressure from soft tissue and centers the rider’s weight on the bone structure (ischial tuberosity and pubic rami) that was intended to support weight when we sit. Because your weight is in a new place it takes the body a few rides to fully adapt and “break-in” to this new position just like starting any new workout there might be some soreness but this goes away with a little bit of time. Once you have adapted you not only have the comfort from eliminating any compression of the pudendal nerve and artery thus eliminating any restriction of blood flow or numbness but you will also not have the sensation of “feeling” the bone structure to any significant degree.
As far as positioning, from the picture I would not tilt the saddle any more than you have it now. While this is a highly personal adjustment too many people tilt the saddle to get the nose out of the way. The ISM does not have a nose and you seemed to have experienced that sitting forward is the key to comfort as opposed to sitting further back like on a traditional saddle. If you felt you needed to do anything to make a change I would lower your seatpost 2-5mm. The reason for this is that on a traditional saddle the weight and bone structure sinks into the cradle part of the saddle and on an ISM the bone structure is supported on the top layer of the saddle. By lowering the saddle a few mm you are not changing your leg extension or position, you are just accommodating for the difference of where your weight is supported.
I hope this helps but if you have any further questions or need any more information please do not hesitate to call or email and it would be my pleasure to further assist you!!
Best Regards,
Dave Schindler
Technical Commander
Tampa Bay Recreation, LLC/ISM Saddles