I have problems with muscle pain around the hips and lower back. Legs are partially paralyzed, and although I can walk, the muscle tension is different than normal use, and can build up to something akin to a bruise in those areas. I use the Alessi MOB with autos (S&W 3913, 4516 and SIG 220), but I WON'T carry MOB since my problems began with spinal issues. This rig is held by a single Talon clip, on the waistband and under the belt, and raked to an extreme "FBI" muzzle-rear cant, smooth side of the leather is out. The clip is positioned just behind the trigger guard, causing belt tension to hold the gun very close against the side. If I move the rig forward to about 4:30-5:00, it stays VERY flat against my side, slips just enough to keep shirt material from bunching up, and the rake is enough to keep from aggravating the muscle behind the right hip. I can still reach the gun with my left hand in that position, with a little stretch. When the condition is worse than normal, I go to a smaller gun in front of the right hip, in "appendix forward" or belly carry.