Yeah, that guy above had it sticking out in an unrealistic way.
When you get them positioned properly, pretty much all of the sound shoots right into the ear canal, as seen in this photo of my PT15 (click for closeup view):
The other way to wear them in the manner I recommend is to wear them up like a behind the ear IEM. You still insert them into the same spot in the ear, you just point the cables up instead of down. This still gives the same huge sound, but provides much more stability to the earbud when moving around (also getting rid of microphonics). This is a great way to wear the lightweight all-plastic earbuds, as those always want to fall out of the ear (when worn down) due to being so light. Here’s a photo of that method (click for larger view):