Madonna faces a battle to be fully fit in time for the release of her new album after a horse riding accident, according to health and dance experts.
The accident happened at Madonna's English country home
The singer suffered three cracked ribs, a broken collarbone and a broken hand.
The album, Confessions on a Dancefloor, is due out on 15 November - but she is not expected to be able to perform properly for about three months.
Her UK spokeswoman Barbara Charone said: "As far as we know, everything [with the album] is unaffected."
Madonna is famed for her energetic stage routines and is expected to go on tour next summer.
It is not yet known whether any video shoots or promotional appearances will be delayed or changed.
Her US spokeswoman Liz Rosenberg said she was "walking and talking" but added: "I don't know if she's going to be hanging from a disco ball anytime soon."
Aicha McKenzie from Vibes UK, billed as the country's top dance agency, which has worked with Madonna, said dancers normally took three months off after an injury.
"Obviously she's got her new album coming out so she should be just maybe back in time to do the promotion for that," she said.
"But I'd imagine it might kill a few massive, mad dance routines she might have had planned.
Madonna is expected to recover in time for a tour next summer
"You often see her doing splits in her music videos and yoga positions and whatever else - that might have been toned down. The ideas for the promotion might change slightly due to her injuries."
But Madonna has a big advantage because she is so fit and has so much presence she could "just stand on the stage", Ms McKenzie said.
The star should make a full recovery, though, and it is unlikely to force her to slow down in the future, she said.
Physiotherapist Elizabeth Sharp, whose company ES Physical Health treats West End performers, said it would take "a couple of months at least" before the singer was able to do an energetic stage show.
And it may be longer, depending on how bad the injuries are, according to Ms Sharp and her team.
The cracked ribs mean Madonna will be "pretty uncomfortable" for the first three weeks, she said, and it will be hard to sing.
"It's going to be really hard for her to take a deep breath because of those ribs so she isn't going to want to belt out," she said.
"But of course she can sing gently and hum to keep the vocal chords working."
Madonna may also be at risk of a collapsed lung if the three cracked ribs are next to each other, she said.
"She's got a medical problem here and needs to be well looked after by a doctor to make sure that lung is actually expanding."
The singer must try to keep the lung "moving through the pain but obviously to rest at the same time", Ms Sharp added.
And Leela Biant, an orthopaedic surgeon at Lister Hospital in Stevenage, Hertfordshire, said the star was unlikely to need surgery.
"The fact that Madonna is very fit and healthy will help her recovery and because she does a lot of yoga she will be used to deep breathing," she said.
"It will be more painful than taking small, shallow breaths, because it moves the ribs more - but it is important."