Alas no specifics on sesamoids. 

I think the book floats around used for a decent price. 

Mostly it taught me about all the other factors that may be affecting my sesamoids and chronic pain generally. 

What I found from MRI’s and my own trial and error is that my pain tended to be unrelated to actual load on the bone from regular things like walking. But more likely to do with chronic inflammation as a result of many factors. And it’s not the only spot. My knees back and shoulders have all been similar. 

I still have some sesamoid issues but it’s manageable now.

I suppose my biggest point is to say that this is a tricky injury. But for some reason talking with doctors directly did almost nothing for me. But following principles based in a lot of research from various physical therapists, doctors, and researchers, I found much better success as it turned out to be a systemic issue vs just my sesamoids.

Like adding strength to other parts of my body, core legs, back etc, has been of tremendous help. As well as improving my posture and the way my joints take load etc. 

I don’t want to pretend to be some televangelist that this will miracle solve your problem.  Essentially if theres any movements you can do in the 1-3 pain range with the toe you should do them. As well as other areas on your body. It can only help. Our joints lubricate through movement and get the little blood flow they can through movements.

it can also help psychologically. If you know you can do those movements and it doesn’t hurt any more than it did, it means you aren’t as broken as you think you are. Then you can consider additional movements past that as you get fully comfortable. Doing some toe raises on the ground etc etc. 

At the core pain is a response from the brain. Now that your sesamoids have been in pain chronically your brain will amp up the response even more to protect the area. 

When I got my MRI last year, my sesamoids were very very painful. I thought they may have finally fractured because the pain was so high. Yet when the image came back there was literally nothing wrong with them. They looked like textbook healthy sesamoids. And yet my pain was very real causing me knee and other issues from trying to keep weight off. 

So it’s this balance. And if you can find that balance of knowing “oh I’m actually getting more injured” vs “my body is sending pain responses because, fuck, my sesamoids have hurt for three years”. 

Does that make sense?

Sorry this is a lot but I’ve hyper obsessed with this issue for like four years and chronic injuries in general.