The last time I saw Madonna, she fell down the stairs. Although, more to the point, she got straight up again and performed a dance routine. I myself recently fell down a flight of stairs, and as I lay at the bottom, curled up in a foetal position, swearing like Ant Middleton, the image of Madonna flashed through my mind. It took me all evening to recover, and as I nursed my bruises with an ice pack, cups of tea, two paracetamol and a Valium, I remembered Madonna at the Brit Awards in 2015. After her fall she was back onstage within seconds, confirming what we all know about her: that she is NAILS. It’s both her strength and her weakness.

I’m here to see her tonight at the Palladium in central London, an intimate venue for such a superstar, and this evening is another recovery on her part: a total of ten earlier shows on this tour had to be cancelled, including the first London date. She has injuries apparently, and has been seen in online footage warming up backstage wearing elasticated knee supports. She looks amazing in knee supports, and it makes me wonder why we don’t all wear them as fashion items. Perhaps we soon will.

Anyway, full disclosure: there was a time, years ago, when I didn’t totally love Madonna. In truth, I think I was jealous of her. She didn’t offer me as obvious a role model as my late-Seventies dark-haired punky heroines, and I found her blonde glamour both entrancing and threatening. In the early Eighties she brought sexy back, and sharing the same record label with her was sometimes a dispiriting experience. Her style became the template for female pop stars, and she threw many of us into the shade, making our indie puritanism look dated and, well, puritanical.

I also thought for a while that I didn’t love her voice, but in retrospect I think I was just being bitchy. Then I came to my senses and realised what a great instrument it is, able to cut through the densest arrangements, dominate any dance floor, and leap out of your radio; instantly identifiable, triumphant and celebratory. Those are the moods she does best, which is what I meant earlier about her toughness being a weakness as well as a strength. You don’t go to Madonna for vulnerability, or confessional songwriting. For someone so open in so many ways, she retains a kind of dignity and privacy as a performer. Onstage, she is MADONNA, and she is all about self-determination, pleasure and defiance.

The defiance has always been there. “Don’t” is one of her favourite words. Every ten years or so she explicitly tells us not to tell her what to do. It started back in 1986 with “Papa Don’t Preach”, a lyric in which a woman literally defies the patriarchy by refusing to be cowed by her father’s morality. In 2000 she recorded “Don’t Tell Me”, with its crystal-clear lyric, “don’t tell me to stop”, and in 2008 she was still fighting back against those who would have her slow down, singing, in “Give it 2 Me”, “don’t stop me now, don’t need to catch my breath, I can go on and on and on”. I soon recognised this defiance in her, and saw that she wielded a sword every bit as powerful as anything brandished by Patti or Poly or Siouxsie.

Tonight, as she appears on the stage, the audience rise as one, giving her a standing ovation that lasts for the full two hours of the show. We sit for a couple of brief moments, but otherwise remain on our feet in her presence, and it seems appropriate. You don’t need me to tell you the show is spectacular, what else would it be? Projected images dazzle and challenge, the stage transforms, the costumes keep coming, the dancers don’t miss a beat. And nor does Madonna herself. Of course she doesn’t. Bitch, she’s Madonna. So no, we don’t get many of the hits, and yes, we do get most of the new album, which is never what an artist’s fans would choose were they to do the choosing. But while Madonna is a great entertainer, she’s no craven crowd-pleaser. The job of keeping herself interested is what, I suspect, motivates her. Churning out the old hit singles would make for a very different kind of concert, one that she would have no interest in.

Instead, we get a show that is a kind of art-pop West End musical that reminds me of the films and pop videos made by Derek Jarman: not afraid to be grandiose, or even pretentious, knowing that great pop is strong enough to bear the weight of both those things without collapsing. She has always played with imagery that is religious, or militaristic, full of big bold symbols, harnessing a kind of camp rebelliousness which is serious without being dull.

In her music, she doesn’t often offer glimpses of sadness or pain, always seeming more authentic when she’s fighting back against that pain, or dancing through it. Though tonight there is one moment of near-vulnerability, when she performs a truly moving version of the song “Frozen”. The staging is suddenly dominated by huge, full-screen images of her daughter, while Madonna is picked out by a spotlight mid-stage, so that she seems to be held aloft, cradled by her dancing daughter. They are entwined, and it’s beautiful, and a moment of rare simplicity.

She ends the show with “Like a Prayer” and we all sing as if we were in church, as if we were true believers, which I guess we are. She is still fighting back against those who would stand in her way. On the track “Future”, from her current album Madame X, she sings, “don’t tell me to stop ‘cause you said so”. The message is loud and clear, and every inch of her proclaims, usually in the face of criticism from men, “DON’T TELL ME WHAT TO DO”. I am sure some doctor somewhere is currently telling her to tone the show down, go easy on her knees, not exacerbate any joint issues, and I think “well good luck with that, doc”, as I watch her, once again, doing everything the male pop stars do, but backwards and in heels. And better.

Madonna’s “Madame X” tour continues at the London Palladium until 16 February