have no problem with track geometry(i miss it actually). i had a bianchi pista and now i have a converted lemond.
i think one get use to it. just shift positions timely and ride the different positions on the bars.
try taking up rock climbing and you'll know what hand/finger soreness is all about.
back to track bikes though...i would worry more about the inability in coast
but you'll get use to that as well. once you're hooked, forget about single speed all together!!