On the last long run of my 2nd marathon training cycle, at mile 12 of a 22 miler, I tripped and landed very hard on my right foot.....well that did it. Sesamoid fracture. Since then I'm totally non weight bearing, in a cast, crutches, the whole nine yards. Determined as I am to return to running healthy in the future, I'm thinking towards a good plan to make a comeback (hey its better than the first 10 days of crying and mopping around). Any suggestions on the best way to return? I'm not really expecting to be back to any kind of real training until January. I scheduled 2 half marathons for the spring and deferred my marathon to fall 2013. 2013 will pretty much be a repeat of 2012 without the injury I hope.
You'll probably get more help on this one, but my general advice is to trust the rehab the same way you trust your training. Don't give up and don't push too hard too soon. Expect this to take a while, as many have reported. Avoid surgery, since it is a crap shoot for active persons like yourself. Once your brain tunes in to a particular pain source, it can become hypersensitive to pain in the area. Taking your rehab a day at a time is part of the process of relearning how to use the injured area, and confidence building.
Beyond that, there are probably more exercises down the line that can be tweaked to strengthen the tissues around your phalangeal joint in preparation for a return to running. Plantarflexion of the toes may be an example, but this down time is also an opportunity to examine the biomechanics of your foot for any condition that might predispose you to sesamoid injury. Here's an interesting and informative article on the subject, and another.