A high-speed chase. Dodging police, drug lords and bullets. Running down a street and ducking into an alley, only to be sucker slammed by a 2-by-4!
A few hours of this and parents might expect their children to walk, or hobble, away with more than a few bumps and bruises -- unless, of course, the action is from a video game.
Games such as "Grand Theft Auto IV," the latest offering to the gaming world, provide plenty of opportunities to engage in brutal high-tech fisticuffs and frequent explosive use.
But now, some doctors are saying that even a virtual rumble can result in real chronic muscle pains.
Picture a gamer, tense, immobile and totally focused on the action on the screen. In all likelihood the pose is not a comfortable one, though the gamer may not realize it until the game is over.
"I guess you could put it that I play a lot," said Mitchel Gianoni, 21, an avid gamer from Massachusetts, who logs a few hours of video game play each day and counts the "Grand Theft Auto" games as some of his favorites. "Yeah, it hurts, if I'm sitting uncomfortably."
And those tense muscles, held in one position for a sustained period of time, can cause painful inflammation and sore areas. Trigger points -- tiny areas where the muscle spasms -- can occur, too.
"It's the muscle's way of saying 'whoa, we're stressed out!'" said Dr. Michael Schmitz, director of pediatric pain medicine at Arkansas Children's Hospital. "Eventually, you can't voluntarily relax that muscle."
Playing in Pain
And being immobile during play doesn't help. Muscles can lose their tone and conditioning very quickly. Schmitz said bedridden patients in hospitals are particularly prone to having painful muscle spasms from lack of use, sometimes within two or three days.
While it may be easier for a child or teenager to shake off a few hours of game playing with nothing more than a sore neck or back, it is far harder for an adult to do the same, so the pain problem may be worse for the growing number of adult gamers.
According to the Entertainment Software Association, the average video game player is 35 and has been playing for 12 years. The U.S. Department of Labor reports that adults average four to five hours each day spent on the computer or in front of the television.
Although a few hours of sitting and playing a video game probably won't do much damage, especially for a young or healthy player, those hours, coupled with an intense game played over many days, could be painful.
Schmitz added that violent games may cause more painful muscle tensing, particularly in the back, shoulders and neck, than other games as players fight their virtual battles.
But few gamers would be willing to give up the action.
"The more action the better," said Timothy Fenton, 19, a 3-D animation and video game design major at New Hampshire Technical Institute in Concord, N.H. "The violence aspect adds to it. You get into the game. You actually feel the rush of being there."
Players extol games you can get into, but the engrossing nature of violent games and the focus required to play them can override pain sensations.
"The point is that kids get so absorbed in these types of entertainment activities that they are distracted from everything else," including their own bodies, Schmitz said.
Triumph or Die
Some have put this theory to the test.
Bryan Raudenbush, an associate professor of psychology at Wheeling Jesuit University in West Virginia, had subjects immerse their hand and forearm in a bowl of icy water and report how much pain they were in every 30 seconds.
Raudenbush found that subjects playing action- and fighting-based games, especially with a first-person game view where they feel they are in the middle of the action, kept their hands in the water bath for more than a minute longer than people playing puzzle or sporting games, as well as reporting feeling less pain.
Other studies have turned up similar results.
"First-person fighting action games are so mentally demanding," Raudenbush said. "The pain doesn't feel as bad."
But harnessing the distracting qualities of dynamic, action-filled video games could give them new potential for pain management. Other studies that turn up results similar to Raudenbush's propose using these games in conjunction with painful situations such as injections or getting burn treatment to help patients cope with their pain.
"I can very much see games having a placebo effect of sorts because of their engaging nature," said Quinton Miles, 25, editor of GameArgus.com, a blog for video game enthusiasts.
Ben Sawyer, a gamer for 30 years and co-founder of the Games for Health project, an initiative to bring together game developers and health-care professionals, believes video games have a definite place in health care.
In addition to the distraction qualities of more sedentary or hand-held video games, interactive and physical games like "Dance Dance Revolution" and the Nintendo Wii can be beneficial for rehabilitation and for exercise.
"As games mature … and become about more than just moving your thumbs … it won't be the same discussion," Sawyer said.