I own and use 6 ball heads from micros for strobes and rangefinders to a big Arca-Swiss, I only own one pan and tilt head and that is for video only. I have no problems using a ball head with LF, easy peasy since you just flip the back to go vertical.
If I am trekking, and I do a lot, I use a Manfrotto 496 on a medium set of CF legs, center colum weight is key. The head weighs .71 lbs, supports over 13 pounds so it handles my 4 to 4.5 pound 45N-2 and lens easily. It costs $61 from B&H, hard to beat, no creep.
The best head out there for the money is the Acratech GP at $400, it is one pound, handles 25 and is in another league in design, I use it for both fresh underwater time exposures and as a gimbal with my gyro for HDSLR video work, sick piece of gear...