As it turns out, the singer did hurt herself in the tumble, saying on ITV's The Jonathan Ross Show in Britain, "I didn't hurt my butt; I hurt my head. I know how to fall. I've fallen off my horse many times, and I tucked, and I have good core strength...but the thing is, I had a little bit of a whiplash, and I smacked the back of my head. So, there was a man standing over me with a flashlight until about 3 a.m. making sure that I was still compos mentis."
"It was a horrible nightmare," she continued. "Seriously, I rehearse and I rehearse and I rehearse so that when I do the show it's effortless and I create magic, and I did the opposite. I actually created a horror show for everyone."
As for how the fall went down, Madonna said the whole performance felt different to her from the beginning, adding, "I was thrown a wrench at the very beginning of my entrance. I was told to tie my cape and start much further back than we had rehearsed."
"Everybody was worried that my cape was going to slide off because it's quite heavy, so they tied it really tight around my neck," she continued. "So here I am marching in like a queen, and I got to the top of the stairs and I pulled my silky string, and it would not come undone. And my two lovely Japanese dancers basically strangled me off the stage. I had a choice: I could either be strangled or fall with the cape, and I fell."
In spite of the embarrassment, Madonna did find humor in the irony of the lyrics of the song she was singing – Living for Love – which includes phrases like, "Took me to heaven and let me fall down" and "Lifted me up, and watched me stumble."
"I'm never writing lyrics like that again! The universe was trying to teach me a lesson, I guess," she joked. Following her fall at the awards show, Madonna managed to get up and continue her performance even though she was injured. And that's why she makes the big bucks.