In reply to iamaclimber:
Have you tried lacing them differently? I used to lace mine over the top hooks first, then tighten over the hooks beneath these. That moved the pinch point (where the knot is) lower down.
I've also skipped an eyelet before to relieve pressure across the to of the foot. That worked well.
Worth messing about with a few different lacing options to see if one works for you.
The other one might be a tongue insert if the boots are tightened right up around the ankle (ie the lacing hooks are almost touching/closed around the front).