Yes, that looked like it hurt. Even worse, Madonna dropped her mic and missed singing several of the song's lyrics entirely. When she picked the mic back up, her voice still seemed shaky, like the fall had knocked the wind out of her. On the plus side: those who accuse her of lip-syncing (Elton John) can sod off.
Ever the pro, though, she recovered by the end of the number and looked triumphant, and maybe a little relieved, when she wrapped.