@ selnor
I do think what you are used to plays a role with what your preferences are.
For driving the left stick is usually steering. Also the right trigger for acceleration and left for slowing down or driving backwards.
The right stick is for viewing around, I have no issue pushing both sticks into any direction on the Sixaxis. My girlfriend is good at Motorstorm, she seems to endure no limitations. So the Sixaxis can work well with both small (gf) or big hands (mine).
Actually I am a physical therapist. It should normally be easier to move around in the 45 degrees position of the thumb.







