Screening mechanisms are essential features of dark energy models mediating a fifth force on large scales. We study the regime of strong scalar field nonlinearities, known as Vainshtein screening, in the most general scalar-tensor theories propagating a single scalar degree of freedom. We first develop an effective approach to parametrize cosmological perturbations beyond linear order for these theories. In the quasistatic limit, the fully nonlinear effective Lagrangian contains six independent terms, one of which starts at cubic order in perturbations. We compute the two gravitational potentials around a spherical body. Outside and near the body, screening reproduces standard gravity, with a modified gravitational coupling. Inside the body, the two potentials are different and depend on the density profile, signalling the breaking of the Vainshtein screening. We provide the most general expressions for these modifications, revising and extending previous results. We apply our findings to show that the combination of the GW170817 event, the Hulse-Taylor pulsar and stellar structure physics, constrain the parameters of these general theories at the level of 10-1, and of Gleyzes-Langlois-Piazza-Vernizzi theories at the level of 10-2.