For the Create Routes geoprocessing tool, why not replace the relative directional choices (upper left, lower left, upper right, lower right) with absolute compass directions (NW, NE, SW, SE) to be more clear for the user. North is not always up even in GIS.
To refine this, one compass direction could take priority over another when creating routes; e.g.North having a greater priority than West for route features having a lot of bends.